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Kidney Focused Care, Llc

NPI Registration Record

Provider / OrganizationNPIDate Certified
KIDNEY FOCUSED CARE, LLC10034189972020-11-14
Entity TypeOrganization
Provider OrganizationKIDNEY FOCUSED CARE, LLC
Practice Office Address2633 RIDGEWOOD RD STE 105
JACKSON, MS US
Practice Office Telephone6016654429
Practice Office Fax6016654429
Mailing Address702 PECAN CT
BRANDON, MS 390426012 US
Business Telephone6627199120
Business Fax6016654429
Authorized OfficialJACQUELINE DIANE BOYD, OWNER
6627199120
HPT Codes
CodeLicense NoState
363L00000X
363LP2300X PRIMARY
193400000X SINGGroup Code
193400000X SINGGroup Code
OPI Codes
Governmental Registrations [CAGE/NCAGE/DUNS]

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