MEDICARE: TUNICA COUNTY HEALTHCARE AUTHORITY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1811618887
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TUNICA COUNTY HEALTHCARE AUTHORITY

Provider Business Mailing Address
First Line	:	PO BOX 789
Second Line	:
City	:	TUNICA
State	:	MS
Zip	:	38676-0789
Country	:	US
Telephone Number	:	662-357-0012
Fax Number	:	662-357-0021

Provider Business Practice Location Address
First Line	:	1813 HIGHWAY 61 N STE A
Second Line	:
City	:	TUNICA
State	:	MS
Zip	:	38676-9683
Country	:	US
Telephone Number	:	662-357-0012
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF FINANCE
Name	:	BARBARA CONWAY
Credential	:
Telephone Number	:	662-357-3883

Provider Enumeration Date	:	09/08/2022
Last Update Date	:	02/08/2023

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Directions to “TUNICA COUNTY HEALTHCARE AUTHORITY ” Practice Location

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