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General NPI Number Information
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NPI Number | 1154317527
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Entity Type | Organization
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Legal Business Name | STATE OF MISSISSIPPI - UNIVERSITY OF MISSISSIPPI MEDICAL CENTER
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Dates
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Enumeration Date | 09/21/2005
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 2500 N STATE ST
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City | JACKSON
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State | MS
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Zip | 39216
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Country | US
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Telephone | 601-984-1000
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Fax | 601-815-0434
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Provider Business Mailing Address
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Address Line | PO BOX 11407
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City | BIRMINGHAM
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State | AL
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Zip | 35246-2130
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Country | US
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Telephone | 601-984-1000
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Fax |
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Authorized Official
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Title or Position | ASSOCIATE CFO-CLINICAL OPERATIONS
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Name | JEFFREY GRIMSLEY
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Credential |
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Telephone | 601-815-6270
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 11-199
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License Number State | MS
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