Organization · NPI-2
Pediatrust Columbus, LLC
Skilled Nursing Facility, Nursing Care, Pediatric · Columbus, MS
NPI number1639606940
StatusActive
Last updated in NPPESOct 23, 2023
Details
- NPI
- 1639606940
- Entity type
- Organization (NPI-2)
- Legal business name
- Pediatrust Columbus, LLC
- Organization subpart
- No
- Enumeration date
- May 17, 2017
- Certification date
- Oct 23, 2023
- Last updated
- Oct 23, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3140N1450X | Skilled Nursing Facility, Nursing Care, Pediatric | – | – | Yes |
Practice location
2213 5th St NColumbus, MS 39705-2211
Phone 662-570-1957 · Fax 662-470-1035
Mailing address
6700 Jefferson Highway, Building 12, Ste BBaton Rouge, LA 70806
Phone 225-665-6555 · Fax 225-665-6555
Authorized official
Leann Craig
Ceo
2252527633
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