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General NPI Number Information
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NPI Number | 1902538382
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Entity Type | Organization
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Legal Business Name | MISSISSIPPI BAPTIST MINISTRY INC
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Dates
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Enumeration Date | 06/25/2022
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Last Update Date | 06/25/2022
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Provider Practice Location Address
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Address Line | 6 DAVID PATTERSON RD
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City | MOSELLE
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State | MS
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Zip | 39459-9439
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Country | US
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Telephone | 601-596-3786
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Fax | 601-586-8304
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Provider Business Mailing Address
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Address Line | 6 DAVID PATTERSON RD
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City | MOSELLE
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State | MS
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Zip | 39459-9439
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Country | US
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Telephone | 601-596-3786
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Fax | 601-586-8304
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Authorized Official
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Title or Position | ADMINISTRATION
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Name | BRENT BROOME
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Credential |
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Telephone | 601-596-3786
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246RM2200X
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Taxonomy Name | Medical Laboratory Technician
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License Number |
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License Number State |
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