Provider Demographics
NPI:1376557645
Name:CRNC, INC.
Entity Type:Organization
Organization Name:CRNC, INC.
Other - Org Name:PHYSICAL THERAPY SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ADA
Authorized Official - Middle Name:RUTH
Authorized Official - Last Name:BOSARGE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:228-762-2345
Mailing Address - Street 1:3423 PASCAGOULA ST
Mailing Address - Street 2:
Mailing Address - City:PASCAGOULA
Mailing Address - State:MS
Mailing Address - Zip Code:39567-3206
Mailing Address - Country:US
Mailing Address - Phone:228-762-2345
Mailing Address - Fax:228-762-2365
Practice Address - Street 1:3423 PASCAGOULA ST
Practice Address - Street 2:
Practice Address - City:PASCAGOULA
Practice Address - State:MS
Practice Address - Zip Code:39567-3206
Practice Address - Country:US
Practice Address - Phone:228-762-2345
Practice Address - Fax:228-762-2365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-29
Last Update Date:2014-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPT2455225100000X
MSPT0449225100000X
MSPT3565225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS09016039Medicaid
MSC03049Medicare PIN
MS09016039Medicaid
MS5375810001Medicare NSC