Southern Family Urgent Care Llc

LBN: Southern Family Urgent Care Llc
Southern Family Urgent Care Llc is an health care organization with primary practice located at 12303 Highway 49 , Gulfport MS 39503-2780. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Urgent Care, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Ambulatory Health Care Facilities / Urgent Care is the primary health care specialty. Southern Family Urgent Care Llc can be contacted via phone (228) 999-9999, or through Mizell, Amanda R via phone (228) 896-7108.

Contact Information

Primary practice address
12303 Highway 49 Gulfport MS 39503-2780
Phone: (228) 999-9999
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Mizell, Amanda R Family Nurse Practitioner (FNP)
Phone: (228) 896-7108

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Urgent Care 261QU0200X
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X

Profile Details

NPI number 1396379186
LBN Legal business name Southern Family Urgent Care Llc
DBA Doing business as
Authorized official Mizell, Amanda R Family Nurse Practitioner (FNP)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 2nd, 2020
Last updated Feb 14th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396379186 NPPES
Mississippi MEDICAID 03337280

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