ESSENTIAL HEALTH & WELLNESS CLINIC P.A. NPI 1538786090

NPI Information

NPI: 1538786090
Provider Name: ESSENTIAL HEALTH & WELLNESS CLINIC P.A.
Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

CLIA Number: 25D2191238

Address:
5842 GOODMAN RD STE 1
HORN LAKE, MS
ZIP 38637
Phone: (662) 449-6570
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ESSENTIAL HEALTH & WELLNESS CLINIC P.A. is a health service clinic center in Horn Lake, MS. ESSENTIAL HEALTH & WELLNESS CLINIC P.A. NPI is 1538786090. The provider is registered as an organization entity type.

The provider's business location address is:

5842 GOODMAN RD STE 1
HORN LAKE, MS
ZIP 38637-106
Phone: (662) 449-6570

The provider's authorized official is Yolanda Murry .
The authorized official title is Ceo and has the following contact phone number (662) 449-6570.

The CLIA number assigned to this NPI record is 25D2191238 - rural health clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/1/2020 and was last updated on 7/1/2020.

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	261QH0100X	Clinic/Center	Health Service			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: 11/14/2023

NPI Synchronization or Removal

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