Provider Demographics
NPI:1659011567
Name:PARKWAY HEALTH & REHAB, LLC
Entity Type:Organization
Organization Name:PARKWAY HEALTH & REHAB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHELTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-956-8276
Mailing Address - Street 1:13 NORTHTOWN DR STE 220
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39211-3047
Mailing Address - Country:US
Mailing Address - Phone:601-956-8276
Mailing Address - Fax:601-709-0832
Practice Address - Street 1:230 RIVER OAKS DRIVE
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MS
Practice Address - Zip Code:39046-3904
Practice Address - Country:US
Practice Address - Phone:601-956-8276
Practice Address - Fax:601-709-0832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-30
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility