Provider Demographics
NPI: | 1851576201 |
---|---|
Name: | HEALTHCARE PLUS LLC |
Entity Type: | Organization |
Organization Name: | HEALTHCARE PLUS LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | GERALDINE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | CHERRY |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 662-843-5454 |
Mailing Address - Street 1: | PO BOX 4345 |
Mailing Address - Street 2: | |
Mailing Address - City: | CLEVELAND |
Mailing Address - State: | MS |
Mailing Address - Zip Code: | 38732 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 662-843-5454 |
Mailing Address - Fax: | 662-843-4550 |
Practice Address - Street 1: | 203 WEST SUNFLOWER ROAD |
Practice Address - Street 2: | |
Practice Address - City: | CLEVELAND |
Practice Address - State: | MS |
Practice Address - Zip Code: | 38732 |
Practice Address - Country: | US |
Practice Address - Phone: | 662-843-5454 |
Practice Address - Fax: | 662-843-4550 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2008-01-04 |
Last Update Date: | 2008-01-04 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 163WH0200X | Nursing Service Providers | Registered Nurse | Home Health | Group - Single Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
MS | 00770486 | Medicaid |