Healthcare Provider Details

I. General information

NPI: 1548710510
Provider Name (Legal Business Name): NORTH SUNFLOWER MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2016
Last Update Date: 10/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

860 N OAK AVE
RULEVILLE MS
38771-3227
US

IV. Provider business mailing address

860 N OAK AVE
RULEVILLE MS
38771-3227
US

V. Phone/Fax

Practice location:
  • Phone: 662-756-2711
  • Fax: 662-756-4621
Mailing address:
  • Phone: 662-756-2711
  • Fax: 662-756-4621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARY FRANKLIN
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 662-756-4620