Healthcare Provider Details

I. General information

NPI: 1093396830
Provider Name (Legal Business Name): MISSISSIPPI METHODIST HOSPITAL & REHABILITATION CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2021
Last Update Date: 04/14/2021
Certification Date: 04/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

993 TOMMY MUNRO DR STE A
BILOXI MS
39532-2178
US

IV. Provider business mailing address

1350 E WOODROW WILSON AVE
JACKSON MS
39216-5112
US

V. Phone/Fax

Practice location:
  • Phone: 228-220-3050
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: GARY ARMSTRONG
Title or Position: CFO
Credential:
Phone: 601-364-3485