1144326547 NPI number — BAPTIST MEMORIAL HEALTH SERVICES, INC. OF MISSISSIPPI

Table of content: (NPI 1144326547)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144326547 NPI number — BAPTIST MEMORIAL HEALTH SERVICES, INC. OF MISSISSIPPI

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BAPTIST MEMORIAL HEALTH SERVICES, INC. OF MISSISSIPPI
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:
GOLDEN TRIANGLE HEART & VASCULAR
Provider Other Organization Name Type Code:
5
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:
1144326547
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/16/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
350 N HUMPHREYS BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MEMPHIS
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
38120-2177
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
901-227-7463
Provider Business Mailing Address Fax Number:
901-227-5699

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
255 BAPTIST BLVD
Provider Second Line Business Practice Location Address:
SUITE 305
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39705-2011
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
662-244-2288
Provider Business Practice Location Address Fax Number:
662-244-2289
Provider Enumeration Date:
09/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
POUNDS
Authorized Official First Name:
DONALD
Authorized Official Middle Name:
R
Authorized Official Title or Position:
CFO SENIOR VICE PRESIDENT
Authorized Official Telephone Number:
901-227-7463

Provider Taxonomy Codes

  • Taxonomy code: 208G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363AS0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 07325029 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".




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