Provider Demographics
NPI:1831672435
Name:HEALTHCAREONTHEGO, LLC
Entity Type:Organization
Organization Name:HEALTHCAREONTHEGO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:TEARRAH
Authorized Official - Middle Name:
Authorized Official - Last Name:CONERLY
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:601-938-0947
Mailing Address - Street 1:3901 KING RD
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39305-2533
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3901 KING RD
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39305-2533
Practice Address - Country:US
Practice Address - Phone:601-938-0947
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-10
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service