Fairuza Zan Trust
LBN: Fairuza Zan Trust
Fairuza Zan Trust is an health care organization with primary practice located at 6569 Highway 305 N , Olive Branch MS 38654-3044. The organization recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, Agencies / Early Intervention Provider Agency. Agencies / Early Intervention Provider Agency is the primary health care specialty.
Fairuza Zan Trust can be contacted via phone (901) 870-1246, or through Gray, Iris via phone (901) 870-1246.
Contact Information
Primary practice address
6569 Highway 305 N
Olive Branch MS 38654-3044
Phone: (901) 870-1246
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist | 225X00000X | ||
| Agencies / Early Intervention Provider Agency | 252Y00000X |
Profile Details
| NPI number | 1508449372 |
|---|---|
| LBN Legal business name | Fairuza Zan Trust |
| DBA Doing business as | |
| Authorized official | Gray, Iris OTR/L |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Apr 29th, 2021 |
| Last updated | Sep 8th, 2023 - about 2 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1508449372 | NPPES |
| Mississippi | MEDICAID | 01820347 |
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