MOBILE HEART STATION INC NPI 1356428569

NPI Information

NPI: 1356428569
Provider Name: MOBILE HEART STATION INC

Former Legal Business Name: MOBILE CV 2000 INC

Classification: Specialist/Technologist Cardiovascular - 246XC2903X
Entity Type: Organization

Specialization: Vascular Specialist

Address:
196 TIMBERLANE ROAD
PICAYUNE, MS
ZIP 39466
Phone: (601) 799-5169
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MOBILE HEART STATION INC is a vascular specialist specialist technologist cardiovascular in Picayune, MS. MOBILE HEART STATION INC NPI is 1356428569. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Mobile Cv 2000 Inc.

The provider's business location address is:

196 TIMBERLANE ROAD
PICAYUNE, MS
ZIP 39466
Phone: (601) 799-5169
Fax: (601) 799-3998

The provider's authorized official is War T Vichayanond .
The authorized official title is President & Ceo and has the following contact phone number (601) 799-5169.

The enumeration date for this NPI number is 11/1/2006 and was last updated on 11/2/2010.

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	Primary
1	246XS1301X	Specialist/Technologist Cardiovascular	Sonography	ARDMS11532	No
2	2471S1302X	Radiologic Technologist	Sonography	ARDMS	No
3	246XC2903X	Specialist/Technologist Cardiovascular	Vascular Specialist	ARDMS11532	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	00117333	MEDICAID	MISSISSIPPI
2	470000006	MEDICARE ID-TYPE UNSPECIFIED	MISSISSIPPI
3	470000422	OTHER	MISSISSIPPI	MEDICARE RAILROAD
4	5CB82	OTHER	LOUISIANA	MEDICARE OF LA

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: 11/14/2023

NPI Synchronization or Removal

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