MUSTANG MEDICINE WORKS, LLC (NPI# 1396127056) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396127056 |
| Entity Type | Organization |
| Organization Name | MUSTANG MEDICINE WORKS, LLC |
| Practice Address |
25 Iselin St Liberty SC 29657-1508 |
| Mailing Address |
Po Box 702 Liberty SC 29657-1508 |
| Practice Telephone | 8645080781 |
| Practice Fax Number | 2063090077 |
| Mailing Telephone | 8645080781 |
| Mailing Fax Number | 2063090077 |
| Enumeration Date | 2015-06-18 |
| Last Update Date | 2015-06-18 |
| Authorized Official Name | DR. DARRELL GENE YARDLEY (C.EO.) |
| Authorized Official Telephone | 8645080781 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
2584 | SC | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124428016 | Mustang Medicine Works, LLC | Counselor | 5642 Moorefield Memorial Hwy., Liberty, SC 29657 | 2014-08-27 |
| Street Address |
25 ISELIN ST |
| City | LIBERTY |
| State | SC |
| Zip Code | 29657-1508 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366825002 | Patricia Pollock Henry | Counselor | 25 Iselin St, Liberty, SC 29657-1508 | 2015-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508233206 | Healing Grace Childbirth Services, LLC | Doula | 306 Burgess Rd, Liberty, SC 29657 | 2015-08-28 |
| 1124428016 | Mustang Medicine Works, LLC | Counselor | 5642 Moorefield Memorial Hwy., Liberty, SC 29657 | 2014-08-27 |
| 1336499706 | Waiyung Florence Ho | Pharmacist | 305 W.main Street, Liberty, SC 29657 | 2012-09-13 |
| 1679822639 | Jennifer Andrews Letourneau | Pharmacist | 305 W.main St, Liberty, SC 29657 | 2012-09-06 |
| 1912256025 | Freddie Honchar | Pharmacist | 429 East Main Street, Liberty, SC 29657 | 2012-09-05 |
| 1720096704 | Emerson Wiggins Rabon Jr. | Dentist | 1074 Anderson Dr, Liberty, SC 29657 | 2006-08-04 |
| 1811476013 | Kathryn Juanita Morrow | Nurse Practitioner | 300 W Front St, Liberty, SC 29657 | 2018-08-08 |
| 1184680134 | James L Wilson | Dentist | 207 W Front St, Liberty, SC 29657-1009 | 2006-04-26 |
| 1154605624 | Bright Smile Center - Liberty, Pa | Dentist | 207 W Front St, Liberty, SC 29657-1009 | 2011-10-03 |
| 1932376035 | Liberty Dental Care, Inc. | Clinic/Center | 207 W Front St, Liberty, SC 29657-1009 | 2008-05-08 |
| Find all providers in zip 29657 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003425448 | Herbert Douglas Geiger | Counselor | 949 Wellington Way, Liberty, MO 64068-1481 | 2020-07-30 |
| 1326683814 | Jacob Laton Wharton | Counselor | 1512 Ne 96th St Ste A, Liberty, MO 64068-7174 | 2019-11-08 |
| 1700321361 | Deena Watkins | Counselor | 9 Victory Dr Ste 2b, Liberty, MO 64068-3807 | 2017-01-05 |
| 1336591890 | Joshua Harms | Counselor | 7 Westowne St, Liberty, MO 64068-1166 | 2016-07-08 |
| 1124428016 | Mustang Medicine Works, LLC | Counselor | 5642 Moorefield Memorial Hwy., Liberty, SC 29657 | 2014-08-27 |
| 1780007344 | Robert Mason Burdine Jr. | Counselor | 314 Springdale Ave, Liberty, SC 29657-3807 | 2014-01-31 |
| 1598196123 | Kristi Robin Bohanon | Counselor | 84 Hustonville St, Liberty, KY 42539-3469 | 2013-12-08 |
| 1306186978 | Michael James Davis | Counselor | 1524 Ne 96th St Ste C, Liberty, MO 64068-1380 | 2013-02-19 |
| 1558625343 | Kelly R Brandsgaard | Counselor | 4 Westowne St Ste 403, Liberty, MO 64068-3511 | 2012-06-27 |
| 1629346010 | Joyce K. Baker | Counselor | 1205 W College St, Liberty, MO 64068-1035 | 2011-12-13 |
| Find all providers in LIBERTY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.