OrganizationBeacon Healthcare Associates, PllcNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address5266 Old Hwy 11, Suite 50 Pmb 158, Hattiesburg, MS 39402(601) 909-8006PECOS EnrollmentBased on the most recent information from CMS, provider Beacon Healthcare Associates, Pllc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 6 days ago.Profile DetailsProvider ID1902577174Provider TypeOrganizationFull NameBeacon Healthcare Associates, PllcSubpartNoEnumeration Date9/27/2021Last Updated10/4/2021Contact InformationPractice LocationPractice Address5266 Old Hwy 11, Suite 50 Pmb 158, Hattiesburg, MS 39402Phone(601) 909-8006FaxUnlisted FaxMailing LocationMailing Address5266 Old Hwy 11, Suite 50 Pmb 158, Hattiesburg, MS 39402Phone(601) 909-8006FaxUnlisted FaxAuthorized OfficialNameTucker, Marquita (Manager)Phone(601) 909-8006Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseUnlisted IssuerCode363L00000XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseUnlisted IssuerCode363LP2300XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseUnlisted Issuer