Provider Demographics
NPI:1609102573
Name:SAFEHEART HEALTH SCREENS
Entity Type:Organization
Organization Name:SAFEHEART HEALTH SCREENS
Other - Org Name:LIVEWELL HEALTH SCREENS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/MANAGING MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:WILKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-450-5483
Mailing Address - Street 1:710 S 28TH AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-2585
Mailing Address - Country:US
Mailing Address - Phone:601-450-5483
Mailing Address - Fax:601-450-9355
Practice Address - Street 1:710 S 28TH AVE
Practice Address - Street 2:SUITE A
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-2585
Practice Address - Country:US
Practice Address - Phone:601-450-5483
Practice Address - Fax:601-450-9355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-27
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory