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Contact Information

MB COSTELLO ENTERPRISES LLC
1501 LAKELAND DR STE 251
JACKSON, MS39216-4848
 Phone: 601-321-8000
 Fax: 601-321-8001
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

207LP2900X 05 Physician/Anesthesiology
Indicates primary specialty

NPI Profile & details for MB COSTELLO ENTERPRISES LLC

NPI # 1982996567
LBN Legal business name MB COSTELLO ENTERPRISES LLC
Authorized official BRUCE COSTELLO - (FRANCHISEE)
Entity Organization
Organization subpart 1 No
Enumeration date 05/13/2011
Last updated 09/29/2011 - About 15 years ago
Identifiers n/a
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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