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General NPI Number Information
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NPI Number | 1104138940
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Entity Type | Organization
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Legal Business Name | MISSISSIPPI METHODIST HOSPITAL & REHABILITATION CENTER, INC.
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Dates
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Enumeration Date | 07/09/2010
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Last Update Date | 10/15/2010
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Provider Practice Location Address
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Address Line | 804 1ST ST
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City | CLEVELAND
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State | MS
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Zip | 38732-2310
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Country | US
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Telephone | 662-846-6555
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Fax | 662-846-6655
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Provider Business Mailing Address
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Address Line | 1350 E WOODROW WILSON AVE
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City | JACKSON
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State | MS
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Zip | 39216-5112
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | GARY ARMSTRONG
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Credential |
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Telephone | 601-981-2611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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