4D HEALTHCARE LLC NPI 1164129755

NPI Information

NPI: 1164129755
Provider Name: 4D HEALTHCARE, LLC
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

CLIA Number: 25D2277736

Address:
1324 MILITARY RD
COLUMBUS, MS
ZIP 39701
Phone: (662) 630-5001
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4D HEALTHCARE, LLC is a multi-specialty clinic center in Columbus, MS. 4D HEALTHCARE, LLC NPI is 1164129755. The provider is registered as an organization entity type.

The provider's business location address is:

1324 MILITARY RD
COLUMBUS, MS
ZIP 39701-616
Phone: (662) 630-5001

The provider's authorized official is Tanya S Cockrell .
The authorized official title is Owner/operator and has the following contact phone number (662) 630-5001.

The CLIA number assigned to this NPI record is 25D2277736 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/14/2023 and was last updated on 2/14/2023.

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	Primary
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	No
2	261QP2300X	Clinic/Center	Primary Care	No
3	261QM1300X	Clinic/Center	Multi-Specialty	Yes

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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