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WESLEY HEALTH SYSTEM LLC
Complete NPI Record 1275154619
Clinical Medical Laboratory in Hattiesburg, MS


Overall Rating: 5 out of 5 stars

NPI Status: Active since April 27, 2020

Contact Information

5001 HARDY ST
HATTIESBURG, MS
ZIP 39402
Phone: (601) 268-8000
Fax: (601) 268-5008

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Employer Identification Number EIN
  4. Provider Organization Name Legal Business Name
  5. Provider First Line Business Mailing Address
  6. Provider Business Mailing Address City Name
  7. Provider Business Mailing Address State Name
  8. Provider Business Mailing Address Postal Code
  9. Provider Business Mailing Address Country Code If outside U S
  10. Provider First Line Business Practice Location Address
  11. Provider Business Practice Location Address City Name
  12. Provider Business Practice Location Address State Name
  13. Provider Business Practice Location Address Postal Code
  14. Provider Business Practice Location Address Country Code If outside U S
  15. Provider Business Practice Location Address Telephone Number
  16. Provider Business Practice Location Address Fax Number
  17. Provider Enumeration Date
  18. Last Update Date
  19. Authorized Official Last Name
  20. Authorized Official First Name
  21. Authorized Official Middle Name
  22. Authorized Official Title or Position
  23. Authorized Official Telephone Number
  24. Healthcare Provider Taxonomy Code 1
  25. Healthcare Provider Primary Taxonomy Switch 1
  26. Is Organization Subpart
  27. NPI Certification Date

Complete NPI Dataset

This page represents the complete record for NPI 1275154619. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1275154619
The date that a record was last updated or changed.
Entity Type Code: 2
The code designating the provider’s gender if the provider is a person.
Employer Identification Number EIN: UNAVAIL
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider First Line Business Mailing Address: PO BOX 848488
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Provider Business Mailing Address City Name: DALLAS
Provider Business Mailing Address State Name: TX
Provider Business Mailing Address Postal Code: 752848488
Provider Business Mailing Address Country Code If outside U S : US
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No
Provider First Line Business Practice Location Address: 5001 HARDY ST
Provider Business Practice Location Address City Name: HATTIESBURG
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: MS
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 394021308
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 6012688000
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 6012685008
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 4/27/2020
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 4/27/2020
The date that a record was last updated or changed.
Authorized Official Last Name: WRIGHT
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: JAMES
The first name of the authorized official.
Authorized Official Middle Name: P
The middle name of the authorized official.
Authorized Official Title or Position: VP PHYSICIAN BUSINESS SERVICES
The title or position of the authorized official.
Authorized Official Telephone Number: 6157781502
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 291U00000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: Y
Is Organization Subpart: N
NPI Certification Date: 4/27/2020