MOBILE HEART STATION INC (NPI# 1356428569) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356428569 |
| Entity Type | Organization |
| Organization Name | MOBILE HEART STATION INC |
| Other Organization Name | MOBILE CV 2000 INC |
| Practice Address |
196 Timberlane Road Picayune MS 39466 |
| Practice Telephone | 6017995169 |
| Practice Fax Number | 6017993998 |
| Mailing Telephone | 6017995169 |
| Mailing Fax Number | 6017993998 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2010-11-02 |
| Authorized Official Name | DR. WAR T VICHAYANOND (PRESIDENT & CEO) |
| Authorized Official Telephone | 6017995169 |
| Authorized Official Credential | PHD FASE RDCS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 246XS1301X |
Spec/Tech, Cardiovascular Specialization: Sonography |
ARDMS11532 | Technologists, Technicians & Other Technical Service Providers | |
| N | 2471S1302X |
Radiologic Technologist Specialization: Sonography |
ARDMS | Technologists, Technicians & Other Technical Service Providers | |
| Y | 246XC2903X |
Spec/Tech, Cardiovascular Specialization: Vascular Specialist |
ARDMS11532 | Technologists, Technicians & Other Technical Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | MEDICARE RAILROAD | 470000422 | 01 |
| LA | MEDICARE OF LA | 5CB82 | 01 |
| MS | 00117333 | 05 |
| Other Name | Type Code |
|---|---|
| Mobile CV 2000 Inc | Former Legal Business Name - Organization |
| Street Address |
196 TIMBERLANE ROAD |
| City | PICAYUNE |
| State | MS |
| Zip Code | 39466 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295270684 | Ashley Royerre Talley | Speech-Language Pathologist | 621 W Canal St, Picayune, MS 39466 | 2016-12-21 |
| 1306396213 | Kathy English | Counselor | 102 Roy St, Picayune, MS 39466 | 2016-10-04 |
| 1124379631 | Hancock Medical Health Services, Inc. | Nurse Practitioner | 23350 Highway 43, Picayune, MS 39466 | 2012-09-24 |
| 1578876280 | Joy A. Weidemann | Social Worker | 120 Street A Ste C, Picayune, MS 39466 | 2010-07-22 |
| 1407188477 | Picayune School District | Local Education Agency (LEA) | 706 Goodyear Blvd., Picayune, MS 39466 | 2010-02-02 |
| 1164751079 | Picayune School District Early Head Start | Early Intervention Provider Agency | 1620 Rosa St, Picayune, MS 39466 | 2009-12-24 |
| 1124352505 | Stephanie Deanne Farrell | Speech-Language Pathologist | 201 E. Second Street, Picayune, MS 39466 | 2009-10-01 |
| 1902084007 | Ludwick L Lohnes Dc LLC | Chiropractor | 214 Norwood Street, Picayune, MS 39466 | 2008-01-31 |
| 1932395878 | Prohealth Solutions, Inc | Occupational Therapist | 722 West Canal Street, Picayune, MS 39466 | 2007-09-24 |
| 1669677431 | Terri L Bordelon | Social Worker | 214 N Curran, Suite A, Picayune, MS 39466 | 2007-06-20 |
| Find all providers in zip 39466 | ||||
| Taxonomy Code | 246XC2903X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Spec/Tech, Cardiovascular |
| Specialization | Vascular Specialist |
| Definition to come... |
Please comment or provide details below to improve the information on MOBILE HEART STATION INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.