Provider Demographics
NPI:1891055588
Name:HEALTH CARE FOR LIFE MS, LLC
Entity Type:Organization
Organization Name:HEALTH CARE FOR LIFE MS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:M
Authorized Official - Last Name:GREENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:256-332-5440
Mailing Address - Street 1:576 HIGHLAND COLONY PKWY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-8769
Mailing Address - Country:US
Mailing Address - Phone:601-707-9488
Mailing Address - Fax:
Practice Address - Street 1:576 HIGHLAND COLONY PKWY
Practice Address - Street 2:SUITE 210
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-8769
Practice Address - Country:US
Practice Address - Phone:601-707-9488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH CARE FOR LIFE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-05-29
Last Update Date:2012-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty