Healthcare Provider Details

I. General information

NPI: 1497888788
Provider Name (Legal Business Name): NORTH SUNFLOWER MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 04/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

840 N OAK AVE
RULEVILLE MS
38771-3227
US

IV. Provider business mailing address

840 N OAK AVE
RULEVILLE MS
38771-3227
US

V. Phone/Fax

Practice location:
  • Phone: 662-756-2711
  • Fax: 662-756-4114
Mailing address:
  • Phone: 662-756-2711
  • Fax: 662-756-4114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. BILLY N MARLOW
Title or Position: CEO
Credential:
Phone: 662-756-2919