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General NPI Number Information
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NPI Number | 1649584749
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Entity Type | Organization
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Legal Business Name | BRIDGES HEALTH CLINIC
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Dates
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Enumeration Date | 07/30/2010
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Last Update Date | 07/30/2010
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Provider Practice Location Address
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Address Line | 801 NORTHSIDE DR
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City | NEWTON
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State | MS
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Zip | 39345-2384
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Country | US
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Telephone | 601-683-4200
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Fax | 601-683-4204
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Provider Business Mailing Address
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Address Line | 701 NORTHSIDE DR
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City | NEWTON
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State | MS
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Zip | 39345-2361
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Country | US
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Telephone | 601-683-4200
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Fax | 601-683-4204
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Authorized Official
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Title or Position | FACILITY DIRECTOR
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Name | MRS. DEBBIE J FERGUSON
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Credential |
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Telephone | 601-683-4201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | DMHCMRC (A)
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License Number State | MS
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