OrganizationActive
Phoenix Specialtycare, LLC
NPI 1053495515 · Parenteral & Enteral Nutrition Supplies (DME) · Richland, MS
Provider details
- NPI number
- 1053495515
- Entity type
- Organization
- Primary specialty
- Parenteral & Enteral Nutrition Supplies (DME)Suppliers
- Organization subpart
- No
- Authorized official
- Roland Wall, Manager(601) 932-3815
Specialties & taxonomies
Suppliers
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
199 Interstate Dr
Suite D
Richland, MS 39218-4428
Phone: (601) 932-3815
Street-level locationGet directions
Mailing address
199 Interstate Dr
Richland, MS 39218-4428
Registry dates
- Enumerated
- 2006-10-24
- Last updated
- 2007-10-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.