Provider Demographics
NPI:1194414342
Name:FIRST PRIORITY HEALTHCARE
Entity type:Organization
Organization Name:FIRST PRIORITY HEALTHCARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LEASE
Authorized Official - Middle Name:
Authorized Official - Last Name:WORDLAW
Authorized Official - Suffix:
Authorized Official - Credentials:CFNP
Authorized Official - Phone:662-312-2737
Mailing Address - Street 1:1572 WALTER BELL RD
Mailing Address - Street 2:
Mailing Address - City:STARKVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39759-2996
Mailing Address - Country:US
Mailing Address - Phone:662-312-2737
Mailing Address - Fax:
Practice Address - Street 1:1572 WALTER BELL RD
Practice Address - Street 2:
Practice Address - City:STARKVILLE
Practice Address - State:MS
Practice Address - Zip Code:39759-2996
Practice Address - Country:US
Practice Address - Phone:662-312-2737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-03
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center