Healthcare Provider Details
I. General information
NPI: 1649727447
Provider Name (Legal Business Name): NORTH MISSISSIPPI MEDICAL CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/09/2016
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
199 GRANDSTAND PLACE
TUPELO MS
38804
US
IV. Provider business mailing address
808 VARSITY DR
TUPELO MS
38801-4613
US
V. Phone/Fax
- Phone: 662-377-7337
- Fax: 662-842-1350
- Phone: 662-377-2386
- Fax: 662-377-2057
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR1300X |
| Taxonomy | Rural Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BRUCE
TOPPIN
Title or Position: CORPORATE SECRETARY
Credential:
Phone: 662-377-4229