IMANI COMMUNITY OUTREACH CTR NPI 1669749081

NPI Information

NPI: 1669749081
Provider Name: IMANI COMMUNITY OUTREACH CTR
Classification: Driver - 172A00000X
Entity Type: Organization
Address:
301 E JEFFERSON ST
KOSCIUSKO, MS
ZIP 39090
Phone: (662) 289-7676
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IMANI COMMUNITY OUTREACH CTR is a driver in Kosciusko, MS. The provider is a person employed to operate a motor vehicle as a carrier of persons or property. IMANI COMMUNITY OUTREACH CTR NPI is 1669749081. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

301 E JEFFERSON ST
KOSCIUSKO, MS
ZIP 39090-719
Phone: (662) 289-7676

The provider's authorized official is Tricia B Duncan .
The authorized official title is Biller and has the following contact phone number (601) 878-6945.

The enumeration date for this NPI number is 11/30/2011 and was last updated on 3/12/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	172A00000X	Driver				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00686258	MEDICAID	MISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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