Healthcare Provider Details

I. General information

NPI: 1720279482
Provider Name (Legal Business Name): AMORY MIDDLE SCHOOL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2007
Last Update Date: 08/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 2ND AVE. N.
AMORY MS
38821
US

IV. Provider business mailing address

700 2ND AVE. N.
AMORY MS
38821
US

V. Phone/Fax

Practice location:
  • Phone: 662-256-5658
  • Fax: 662-256-6304
Mailing address:
  • Phone: 662-256-5658
  • Fax: 662-256-6304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberR853749
License Number StateMS

VIII. Authorized Official

Name: SARAH L HODO
Title or Position: REGISTERED NURSE
Credential: R.N
Phone: 662-256-5658