Pure Therapy, Llc | |
7955 Huckleberry Ln Summit MS 39666-7086 | |
(601) 870-4360 | |
Not Available |
Full Name | Pure Therapy, Llc |
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Speciality | Clinic/Center |
Location | 7955 Huckleberry Ln, Summit, Mississippi |
Authorized Official Name and Position | Micaela Temple Andrus (HALF OWNER) |
Authorized Official Contact | 6018704360 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Pure Therapy, Llc 7955 Huckleberry Ln Summit MS 39666-7086 Ph: (601) 870-4360 | Pure Therapy, Llc 7955 Huckleberry Ln Summit MS 39666-7086 Ph: (601) 870-4360 |
NPI Number | 1669251369 |
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Provider Enumeration Date | 09/22/2023 |
Last Update Date | 09/27/2023 |
Medicare PECOS PAC ID | 9032565544 |
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Medicare Enrollment ID | O20231019001364 |
Identifier | Type | State | Issuer |
---|---|---|---|
1669251369 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Provider Name | Micaela Temple Andrus |
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Provider Type | Practitioner - Qualified Speech Language Pathologist |
Provider Identifiers | NPI Number: 1639958333 PECOS PAC ID: 0941656458 Enrollment ID: I20231024002425 |
Pinnacle Medical Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 7900 Highway 570, Summit, MS 39666 Phone: 601-684-7771 Fax: 601-684-1616 | |
Southwest Mississippi Regional Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 802 W Railroad Ave, Summit, MS 39666 Phone: 601-250-4420 Fax: 601-250-4421 | |
Jennifer D Gholson Md, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 804 Robb St, Summit, MS 39666 Phone: 601-276-7665 Fax: 601-276-7655 | |
Southwest Mississippi Regional Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 802 W Railroad Ave, Summit, MS 39666 Phone: 601-250-4420 Fax: 601-250-4421 |