Provider Demographics
NPI:1962688358
Name:PSCH, LLC
Entity Type:Organization
Organization Name:PSCH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:J
Authorized Official - Last Name:TALBOT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:601-296-3405
Mailing Address - Street 1:40 FRANKLIN RD
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-1318
Mailing Address - Country:US
Mailing Address - Phone:601-296-3405
Mailing Address - Fax:601-296-3409
Practice Address - Street 1:40 FRANKLIN RD
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-1318
Practice Address - Country:US
Practice Address - Phone:601-296-3405
Practice Address - Fax:601-296-3409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-15
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical