Healthcare Provider Details

I. General information

NPI: 1346973625
Provider Name (Legal Business Name): QUITMAN COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2022
Last Update Date: 11/01/2023
Certification Date: 11/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 GETWELL ST
MARKS MS
38646-9785
US

IV. Provider business mailing address

340 GETWELL ST
MARKS MS
38646-9785
US

V. Phone/Fax

Practice location:
  • Phone: 662-388-0700
  • Fax: 662-388-0707
Mailing address:
  • Phone: 662-388-0700
  • Fax: 662-388-0707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: BARBARA CONWAY
Title or Position: CREDENTIALING
Credential:
Phone: 662-357-3883