| Peace Wellness Center, Llc | |
|
638 Northwest Ave Durant MS 39063-3337 | |
| (601) 842-7107 | |
| (800) 517-7659 |
| Full Name | Peace Wellness Center, Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 638 Northwest Ave, Durant, Mississippi |
| Authorized Official Name and Position | Pamela Jarrett (CEO) |
| Authorized Official Contact | 6018427107 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Peace Wellness Center, Llc Po Box 93 Vaiden MS 39176-0093 Ph: (601) 842-7107 | Peace Wellness Center, Llc 638 Northwest Ave Durant MS 39063-3337 Ph: (601) 842-7107 |
| NPI Number | 1306111984 |
|---|---|
| Provider Enumeration Date | 03/15/2012 |
| Last Update Date | 03/15/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306111984 | NPI | - | NPPES |
| 03607748 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | R869034 (Mississippi) | Primary |
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