Healthcare Provider Details

I. General information

NPI: 1336180512
Provider Name (Legal Business Name): MERIDIAN HMA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 07/31/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1102 CONSTITUTION AVE
MERIDIAN MS
39301-4001
US

IV. Provider business mailing address

1102 CONSTITUTION AVE
MERIDIAN MS
39301-4001
US

V. Phone/Fax

Practice location:
  • Phone: 601-693-2511
  • Fax: 601-484-3130
Mailing address:
  • Phone: 601-484-3590
  • Fax: 601-484-3130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY PARRY
Title or Position: SR VP AND GENERAL COUNSEL
Credential: ESQ
Phone: 239-598-3176