Provider Demographics
NPI:1548628043
Name:PARAMOUNT HEALTHCARE LLC
Entity type:Organization
Organization Name:PARAMOUNT HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SHIREISLA
Authorized Official - Middle Name:DENAE
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:601-278-4933
Mailing Address - Street 1:819 BRIARFIELD RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39211-4116
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:819 BRIARFIELD RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39211-4116
Practice Address - Country:US
Practice Address - Phone:601-278-4933
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-29
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No347B00000XTransportation ServicesBus
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle