DIAMONDMED URGENT CARE (HANCOCK MEDICAL CENTER) NPI 1003007006

Clinic/Center (Urgent Care) in Diamondhead, MS

NPI 1003007006 Organization Clinic/Center Urgent Care

About DIAMONDMED URGENT CARE (HANCOCK MEDICAL CENTER)

Diamondmed Urgent Care (hancock Medical Center) is a provider established in Diamondhead, Mississippi specializing in clinic/center (urgent care) . The NPI number of Diamondmed Urgent Care (hancock Medical Center) is 1003007006 and was assigned on August 2007. The practitioner's primary taxonomy code is 261QU0200X with license number 11214 (MS). The provider is registered as an organization and their NPI record was last updated 12 years ago. The provider's is doing business as Diamondmed Urgent Care. The authorized official of this NPI record is Mr. Donald L Wade Cpa (Chief Financial Officer)

NPI

1003007006

Provider NameDIAMONDMED URGENT CARE (HANCOCK MEDICAL CENTER)
Provider Location Address4540 SHEPHERD SQUARE SUITE B DIAMONDHEAD, MS 39525
Provider Mailing AddressP.O. BOX 2790 BAY SAINT LOUIS, MS 39521
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?Yes
Other Organization NameDIAMONDMED URGENT CARE
Other Name TypeDoing Business As (3)
Enumeration Date08-05-2007
Last Update Date10-08-2009


Primary Taxonomy

Taxonomy Code261QU0200X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
SpecializationUrgent Care
License No.11214
License StateMS

Business Address

DIAMONDMED URGENT CARE
4540 SHEPHERD SQUARE
SUITE B
DIAMONDHEAD, MS
ZIP 39525
Phone: (228) 255-8216
Fax: (228) 255-8219

Get Directions


Mailing Address

DIAMONDMED URGENT CARE
P.O. BOX 2790
BAY SAINT LOUIS, MS
ZIP 39521
Phone: (228) 467-8700
Fax: (228) 467-8799



Authorized Official

Authorized Official NameMR. DONALD L WADE CPA
Authorized Official TitleCHIEF FINANCIAL OFFICER
Authorized Official Phone(228) 467-8700

Other Providers at the same location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1134305352HANCOCK MEDICAL CENTER
Organization
Orthopaedic Surgery4540 SHEPHERD SQUARE SUITE C
DIAMONDHEAD, MS 39525
(228) 255-8526

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.