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NPI Code Detail

MEDICARE: CLARKSDALE HMA LLC

MEDICARE: CLARKSDALE 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
1273Y00000XRehabilitation Hospital Unit

General Provider Information

NPI Number : 1447297304
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLARKSDALE HMA LLC
Provider Business Mailing Address
First Line : 1970 HOSPITAL DR
Second Line :
City : CLARKSDALE
State : MS
Zip : 38614-7202
Country : US
Telephone Number : 662-624-3401
Fax Number :
Provider Business Practice Location Address
First Line : 1970 HOSPITAL DR
Second Line :
City : CLARKSDALE
State : MS
Zip : 38614-7202
Country : US
Telephone Number : 662-624-3401
Fax Number :
Authorized Official
Title or Position : AUTHORIZED OFFICIAL
Name : LAURIE HOLTSFORD
Credential :
Telephone Number : 615-465-7466
Provider Enumeration Date : 06/01/2006
Last Update Date : 01/28/2014

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Directions to “CLARKSDALE HMA LLC ” Practice Location

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