PRIME HEART AND VASCULAR CARE; NPI #1104434356

Contact Information

PRIME HEART AND VASCULAR CARE

1310 HWY 72E
CORINTH, MS 38834

Phone: 662-594-4123
Fax: 662-594-2296
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Cardiovascular Disease	207RC0000X	11	Physician/Internal Medicine

Indicates primary specialty

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NPI Profile & details for PRIME HEART AND VASCULAR CARE

NPI # 1104434356

LBN Legal business name PRIME HEART AND VASCULAR CARE

Authorized official MANDAR JAGTAP - (PROVIDER)

Entity Organization

Organization subpart ¹ No

Enumeration date 07/14/2020

Last updated 07/07/2021 - About 5 years ago

Identifiers

Medicaid

03005201

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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