MOONEYHAM PROPERTIES NPI 1184913014

NPI Information

  • NPI: 1184913014
  • Provider Name: MOONEYHAM PROPERTIES
  • Classification: Clinic/Center - 261Q00000X
  • Entity Type: Organization
  • Doing Business As: 4 THE FAMILY HEALTHCARE
  • CLIA Number: 25D2022088
  • Address: 1127 OLD FANNIN RD
    C
    BRANDON, MS
    ZIP 39047
  • Phone: (601) 214-4420

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NPI Details

MOONEYHAM PROPERTIES is a clinic center in Brandon, MS. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). MOONEYHAM PROPERTIES NPI is 1184913014. The provider is registered as an organization entity type.
The provider Is Doing Business As 4 The Family Healthcare.

The provider's business location address is:

1127 OLD FANNIN RD
C
BRANDON, MS
ZIP 39047-265
Phone: (601) 214-4420

The provider's authorized official is Jennifer Wedgeworth Mooneyham .
The authorized official title is Provider/owner and has the following contact phone number (601) 214-4420.

The CLIA number assigned to this NPI record is 25D2022088 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/31/2011 and was last updated on 3/31/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/CenterMS845026MISSISSIPPIYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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