| Altheacare Llc | |
|
310 W Sweet Potato St Ste B Vardaman MS 38878-8405 | |
| (662) 567-1282 | |
| Not Available |
| Full Name | Altheacare Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 310 W Sweet Potato St Ste B, Vardaman, Mississippi |
| Authorized Official Name and Position | Jana Earnest (OFFICE MANAGER) |
| Authorized Official Contact | 6625671283 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Altheacare Llc Po Box 207 Vardaman MS 38878-0207 Ph: (662) 567-1283 | Altheacare Llc 310 W Sweet Potato St Ste B Vardaman MS 38878-8405 Ph: (662) 567-1282 |
| NPI Number | 1467177683 |
|---|---|
| Provider Enumeration Date | 10/10/2022 |
| Last Update Date | 02/09/2023 |
| Medicare PECOS PAC ID | 1052789302 |
|---|---|
| Medicare Enrollment ID | O20221117002993 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467177683 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Joy Anita Chapman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427064344 PECOS PAC ID: 5193727972 Enrollment ID: I20070207000344 |
| Provider Name | James M Orender |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1538263058 PECOS PAC ID: 0648212282 Enrollment ID: I20101013000836 |
| Provider Name | Amanda Brand Mahan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720562226 PECOS PAC ID: 0840544573 Enrollment ID: I20181116000679 |