Provider Demographics
NPI:1285332379
Name:ENHANCED CARE LABS & SCREENING
Entity type:Organization
Organization Name:ENHANCED CARE LABS & SCREENING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KENYATA
Authorized Official - Middle Name:
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-590-5325
Mailing Address - Street 1:126 GREENVIEW DR
Mailing Address - Street 2:
Mailing Address - City:PICAYUNE
Mailing Address - State:MS
Mailing Address - Zip Code:39466-3610
Mailing Address - Country:US
Mailing Address - Phone:601-590-5325
Mailing Address - Fax:
Practice Address - Street 1:701 HIGHWAY 11 N STE E
Practice Address - Street 2:
Practice Address - City:PICAYUNE
Practice Address - State:MS
Practice Address - Zip Code:39466-3318
Practice Address - Country:US
Practice Address - Phone:769-216-1415
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center