Provider Demographics
NPI:1669018008
Name:MAXIMUM CARE AFTER HOURS CLINIC, LLC
Entity Type:Organization
Organization Name:MAXIMUM CARE AFTER HOURS CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMARIN
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:662-588-8009
Mailing Address - Street 1:PO BOX 26
Mailing Address - Street 2:
Mailing Address - City:SHAW
Mailing Address - State:MS
Mailing Address - Zip Code:38773-0026
Mailing Address - Country:US
Mailing Address - Phone:662-588-8009
Mailing Address - Fax:
Practice Address - Street 1:212 HIGHWAY 61
Practice Address - Street 2:
Practice Address - City:SHAW
Practice Address - State:MS
Practice Address - Zip Code:38773-3877
Practice Address - Country:US
Practice Address - Phone:662-588-8009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-20
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center