| Children's International, Llc | |
|
15465 Oak Ln Gulfport MS 39503-2663 | |
| (228) 831-8800 | |
| (228) 831-8020 |
| Full Name | Children's International, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 15465 Oak Ln, Gulfport, Mississippi |
| Authorized Official Name and Position | Eduardo Hernandez (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 9856461580 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Children's International, Llc 59101 Amber St Slidell LA 70461-3708 Ph: (985) 646-1580 | Children's International, Llc 15465 Oak Ln Gulfport MS 39503-2663 Ph: (228) 831-8800 |
| NPI Number | 1023549219 |
|---|---|
| Provider Enumeration Date | 03/21/2017 |
| Last Update Date | 03/21/2017 |
| Medicare PECOS PAC ID | 1254633308 |
|---|---|
| Medicare Enrollment ID | O20200311000634 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023549219 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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