Provider Demographics
NPI:1467593012
Name:PITTS NURSING CARE
Entity Type:Organization
Organization Name:PITTS NURSING CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ONWER
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:PITTS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:662-207-4225
Mailing Address - Street 1:416 WESTSIDE AVE
Mailing Address - Street 2:203 HERMON JOHNSON
Mailing Address - City:INDIANOLA
Mailing Address - State:MS
Mailing Address - Zip Code:38751-2752
Mailing Address - Country:US
Mailing Address - Phone:662-207-4225
Mailing Address - Fax:662-887-2374
Practice Address - Street 1:416 WESTSIDE AVE
Practice Address - Street 2:
Practice Address - City:INDIANOLA
Practice Address - State:MS
Practice Address - Zip Code:38751-2752
Practice Address - Country:US
Practice Address - Phone:662-207-4225
Practice Address - Fax:662-207-1856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based