V A South

LBN: V A South
V A South is an health care organization with primary practice located at 4304 Highway 80 W Ste A , Jackson MS 39209-5922. The organization recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist is the primary health care specialty. V A South can be contacted via phone (601) 636-6019, or through Harris, Marcus T via phone (601) 927-7671.

Contact Information

Primary practice address
4304 Highway 80 W Ste A Jackson MS 39209-5922
Phone: (601) 636-6019
Fax: (601) 661-8457
Website:
Map and Directions
Authorized official contact:
Name: Harris, Marcus T Physical Therapist (PT)
Phone: (601) 927-7671

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT3192 Mississippi
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X OT2019 Mississippi

Profile Details

NPI number 1821152877
LBN Legal business name V A South
DBA Doing business as V A South
Authorized official Harris, Marcus T Physical Therapist (PT)
Entity Organization
Organization subpart 1 No
Enumeration date Dec 21st, 2006
Last updated Aug 22nd, 2020 - about 5 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 1821152877 NPPES
Mississippi MEDICAID 00124552

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