Healthcare Provider Details
I. General information
NPI: 1447367834
Provider Name (Legal Business Name): NORTH MISSISSIPPI MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/23/2006
Last Update Date: 09/19/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
990 S MADISON ST STE 2
TUPELO MS
38801-6308
US
IV. Provider business mailing address
990 SOUTH MADISON STREET STE 2
TUPELO MS
38801
US
V. Phone/Fax
- Phone: 662-377-4919
- Fax: 662-377-7236
- Phone: 662-377-4919
- Fax: 662-377-7236
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0004X |
| Taxonomy | Compounding Pharmacy |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336H0001X |
| Taxonomy | Home Infusion Therapy Pharmacy |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336I0012X |
| Taxonomy | Institutional Pharmacy |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336S0011X |
| Taxonomy | Specialty Pharmacy |
| License Number | 04363 |
| License Number State | MS |
VIII. Authorized Official
Name:
PATTI
HAWKINS
Title or Position: DIRECTOR
Credential: PHARMD
Phone: 662-377-4731