Healthcare Provider Details

I. General information

NPI: 1124106612
Provider Name (Legal Business Name): MCCOMB PUBLIC SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 11/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 ELMWOOD STREET LOWER RAMP
MCCOMB MS
39648
US

IV. Provider business mailing address

695 MINNESOTA AVE P.O. BOX 868
MCCOMB MS
39648-4044
US

V. Phone/Fax

Practice location:
  • Phone: 601-249-5138
  • Fax: 601-249-5137
Mailing address:
  • Phone: 601-684-4661
  • Fax: 601-249-4732

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MRS. CATHY JONES
Title or Position: DIRECTOR OF FINANCE
Credential:
Phone: 601-684-4661