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NPI Code Detail

MEDICARE: JACKSON HMA LLC

MEDICARE: JACKSON HMA LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1282N00000XGeneral Acute Care Hospital16240MS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2000020613OTHERMSBLUE CROSS

General Provider Information

NPI Number : 1033163092
Entity Type Code : Organization
Provider Name (Legal Business Name) : JACKSON HMA LLC
Provider Business Mailing Address
First Line : 1850 CHADWICK DR
Second Line :
City : JACKSON
State : MS
Zip : 39204-3404
Country : US
Telephone Number : 601-376-1000
Fax Number : 601-376-2821
Provider Business Practice Location Address
First Line : 1850 CHADWICK DR
Second Line :
City : JACKSON
State : MS
Zip : 39204-3404
Country : US
Telephone Number : 601-376-1000
Fax Number : 601-376-2821
Authorized Official
Title or Position : DIRECTOR/DELEGATED OFFICIAL
Name : PAULA M LALOR
Credential :
Telephone Number : 629-215-3953
Provider Enumeration Date : 05/22/2006
Last Update Date : 04/08/2021

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Practice Location Address:
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JACKSON, MS
39204-3404
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1518969724 — DR. STEVEN E ZACHOW MD
Practice Location Address:
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1730161779 — MR. MARK C. BURRELL CRNA
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Practice Fax: 601-376-1894
1932167533 — STERLING EMERGENCY SERVICES OF MISSISSIPPI, INC
Practice Location Address:
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1114976677 — DR. DAVID A. DEAN D.O.
Practice Location Address:
1850 CHADWICK DR , CENTRAL MISSISSIPPI MEDICAL CENTER EMERGENCY DEPARTMENT
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1407803422 — MR. THOMAS BRADLEY COSGROVE CRNA
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Practice Fax: 601-376-1894

Directions to “JACKSON HMA LLC ” Practice Location

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