Provider Demographics
NPI:1669972089
Name:UNIQUE PROFESSIONAL PCS
Entity type:Organization
Organization Name:UNIQUE PROFESSIONAL PCS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRADY
Authorized Official - Middle Name:
Authorized Official - Last Name:FIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:MR
Authorized Official - Phone:318-758-0857
Mailing Address - Street 1:109 DOTY ROAD
Mailing Address - Street 2:
Mailing Address - City:FERRIDAY
Mailing Address - State:LA
Mailing Address - Zip Code:71334-4241
Mailing Address - Country:US
Mailing Address - Phone:318-758-0857
Mailing Address - Fax:317-757-7159
Practice Address - Street 1:109 DOTY ROAD
Practice Address - Street 2:
Practice Address - City:FERRIDAY
Practice Address - State:LA
Practice Address - Zip Code:71334-4241
Practice Address - Country:US
Practice Address - Phone:318-758-0857
Practice Address - Fax:317-757-7159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-13
Last Update Date:2018-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health