MEDICARE: TYLER HOLMES MEMORIAL HOSPITAL

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
1	261QP2300X	Primary Care Clinic/Center
2	261QR1300X	Rural Health Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2070889	OTHER	MS	WELLCARE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	1497164446	OTHER	MS	NPI
7	1730367459	OTHER	MS	NPI
8	1730550419	OTHER	MS	NPI
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	2163489	OTHER	MS	WELLCARE
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	1659550127	OTHER	MS	NPI

General Provider Information

NPI Number	:	1730367459
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TYLER HOLMES MEMORIAL HOSPITAL

Provider Business Mailing Address
First Line	:	702 WOODLAND DR
Second Line	:
City	:	WINONA
State	:	MS
Zip	:	38967-1530
Country	:	US
Telephone Number	:	662-283-8205
Fax Number	:	662-283-6747

Provider Business Practice Location Address
First Line	:	702 WOODLAND DR
Second Line	:
City	:	WINONA
State	:	MS
Zip	:	38967-1530
Country	:	US
Telephone Number	:	662-283-8205
Fax Number	:	662-283-6747

Authorized Official
Title or Position	:	CLINIC DIRECTOR
Name	:	MRS. MEMORIE LYONS
Credential	:
Telephone Number	:	662-283-6119

Provider Enumeration Date	:	02/05/2008
Last Update Date	:	01/29/2024

Similar Medicare Providers

1881600492 — DR. STEVEN KEITH RUSHING M.D.
Practice Location Address:

700 WOODLAND DR
WINONA, MS
38967-1530

Practice Phone: 662-283-3060
Practice Fax: 662-283-3553

1326452301 — CINDY COLEMAN PTA
Practice Location Address:

700 WOODLAND DR
WINONA, MS
38967-1530

Practice Phone: 662-283-8252
Practice Fax:

1053718205 — MRS. EMILY PARNELL COTA
Practice Location Address:

718 WOODLAND DR
WINONA, MS
38967-1530

Practice Phone: 662-809-7055
Practice Fax:

1861990111 — AMY MARIE GAMMEL FNP
Practice Location Address:

700 WOODLAND DR
WINONA, MS
38967-1530

Practice Phone: 662-283-3060
Practice Fax:

1316557416 — STEPHANIE MELINDA MYERS
Practice Location Address:

700 WOODLAND DR # 1530
WINONA, MS
38967-1530

Practice Phone: 662-283-3060
Practice Fax:

1508909391 — HOWARD WOOLLEY D.C.
Practice Location Address:

3930 W 6TH ST
WINONA, MN
55987-1530

Practice Phone: 507-452-4490
Practice Fax: 507-452-4803

Directions to “TYLER HOLMES MEMORIAL HOSPITAL ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.