Fairuza Zan Trust is a
Early Intervention Provider Agency based in Olive Branch, Mississippi. Fairuza Zan Trust is licensed to practice in * (Not Available) (license number ) and their current practice location is
6569 Highway 305 N, Olive Branch, Mississippi. It can be reached at their office (for appointments etc.) via phone at
(901) 870-1246.
NPI number for Fairuza Zan Trust is 1508449372 and their current mailing address is 6569 Highway 305 N, Olive Branch, Mississippi. Fairuza Zan Trust
does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1508449372.
Healthcare Provider's Profile
Full Name | Fairuza Zan Trust |
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Type | Facility |
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Speciality | Early Intervention Provider Agency |
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Location | 6569 Highway 305 N, Olive Branch, Mississippi |
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Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
NPI Data:
- NPI Number: 1508449372
- Provider Enumeration Date: 04/29/2021
- Last Update Date: 09/08/2023
Medical Identifiers
Medical identifiers for Fairuza Zan Trust such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1508449372 | NPI | - | NPPES |
01820347 | Medicaid | MS | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
225X00000X | Occupational Therapist | (* (Not Available)) | Secondary |
252Y00000X | Early Intervention Provider Agency | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Fairuza Zan Trust is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Fairuza Zan Trust 6569 Highway 305 N, Olive Branch, MS 38654-3044 Ph: (901) 870-1246 | Fairuza Zan Trust 6569 Highway 305 N, Olive Branch, MS 38654-3044 Ph: (901) 870-1246 |
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