Copac Addiction Services

NPI 1073679817 - Substance Abuse Rehabilitation Facility - 324500000X

NPI Details
NPI 1073679817
Enumeration Date 12/28/2006
Last Updated 06/25/2010
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name WANDA NEWTON WANDA
Position FAMILY NURSE PRACTITIONER
Phone (601) 829-2500
Fax (601) 829-4278
Practice Location
3949 HIGHWAY 43 N
BRANDON MS, 39047-7240, US
Phone (601) 829-2500
Fax (601) 829-4278
Business Location
5857 KRISTEN DR
JACKSON MS, 39211-2831, US
Phone (601) 956-0303
Fax
Toxanomy
Taxonomy Code 324500000X
License State Mississippi
License Number R586986
Remove 1073679817 NPI Number
 

According to our database, Copac Addiction Services NPI is 1073679817, taxonomy code is 324500000X and license number is R586986, license state is located at Mississippi. Copac Addiction Services physically located at 3949 Highway 43 N, Brandon MS, 39047-7240. NPI Number 1033115704 has the healthcare provider type.

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1073679817 NPI number is provided on an as is basis without warranty of any kind. 1073679817 is maintained by the National Plan & Provider Enumeration System. The contents of Copac Addiction Services are for informational purposes only.