Provider Demographics
NPI:1316686827
Name:PLUNKETT DBA PRECISIONPATH,LLC, MITREASE
Entity type:Individual
Prefix:
First Name:MITREASE
Middle Name:
Last Name:PLUNKETT DBA PRECISIONPATH,LLC
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 SQUIRREL HILL DR
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-4025
Mailing Address - Country:US
Mailing Address - Phone:662-590-6674
Mailing Address - Fax:662-590-6674
Practice Address - Street 1:101 SQUIRREL DRIVE
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-3915
Practice Address - Country:US
Practice Address - Phone:662-590-6674
Practice Address - Fax:662-590-6674
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-02
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)