CCN: 257147 NPI: 1891169306 Organization

INTREPID USA HEALTHCARE SERVICES

885 FERNCLIFF DRIVE , SUTIES 1 & 3
SOUTHAVEN, MS 386712433

Contact Information

Phone 6623930109
Fax 6623934306
Enumeration Date 2015-11-20
Last Updated 2019-10-01

Taxonomies

Code: 251E00000X (Primary) License State: MS License: 7294

Inpatient Payment Attributes (IPSF) View Dictionary →

Effective Date:

censusDivision 5

cbsaActualGeographicLocation 32820

providerType 36

censusDivision 5

cbsaActualGeographicLocation 32820

providerType 36

censusDivision 5

cbsaActualGeographicLocation 32820

providerType 36

censusDivision 5

cbsaActualGeographicLocation 32820

providerType 36

censusDivision 5

cbsaActualGeographicLocation 32820

providerType 36

censusDivision 5

cbsaActualGeographicLocation 32820

providerType 36

censusDivision 5

cbsaActualGeographicLocation 32820

providerType 36

censusDivision 5

cbsaActualGeographicLocation 32820

providerType 36

Outpatient Payment Attributes (OPSF) View Dictionary →

Effective Date:

cbsaActualGeographicLocation 32820

providerType 36

specialPaymentIndicator

carrierCode 07302

localityCode 00