1215069018 NPI number — FRANKLIN COUNTY MEMORIAL HOSPITAL

Table of content: (NPI 1215069018)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215069018 NPI number — FRANKLIN COUNTY MEMORIAL HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FRANKLIN COUNTY MEMORIAL HOSPITAL
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215069018
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/07/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 636
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MEADVILLE
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
39653-0636
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
601-384-8100
Provider Business Mailing Address Fax Number:
601-384-4100

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
40 UNION CHURCH RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MEADVILLE
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39653-8336
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
601-384-8100
Provider Business Practice Location Address Fax Number:
601-384-4100
Provider Enumeration Date:
03/09/2007

Additional Information

Authorized Official

Authorized Official Last Name:
DILLON
Authorized Official First Name:
ALEDA
Authorized Official Middle Name:
JEAN
Authorized Official Title or Position:
INSURANCE DIRECTOR
Authorized Official Telephone Number:
601-384-8112

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  11175 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00120619 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00110171 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00121418 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 08602887 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 09012397 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00012941 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000019130 . This is a "EMERGENCY ROOM BLUE CROSS" identifier , issued by the state of ( MS ) . This identifiers is of the category "OTHER".
  • Identifier: 00011530 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".




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