Provider Demographics
NPI:1619201423
Name:MISSISSIPPI FIRST ASSIST, LIMITED LIABILITY COMPANY
Entity Type:Organization
Organization Name:MISSISSIPPI FIRST ASSIST, LIMITED LIABILITY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CST-CFA/MEMBER IN CHARGE
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:H
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:CST/CFA
Authorized Official - Phone:601-214-2373
Mailing Address - Street 1:150 HOLMAR DR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:MS
Mailing Address - Zip Code:39047-9550
Mailing Address - Country:US
Mailing Address - Phone:601-214-2373
Mailing Address - Fax:
Practice Address - Street 1:150 HOLMAR DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:MS
Practice Address - Zip Code:39047-9550
Practice Address - Country:US
Practice Address - Phone:601-214-2373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-25
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Single Specialty