1124635180 NPI number — HIGHLAND CENTER FOR WOMEN'S HEALTH

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124635180 NPI number — HIGHLAND CENTER FOR WOMEN'S HEALTH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HIGHLAND CENTER FOR WOMEN'S HEALTH
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:
1124635180
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/24/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
125 S 28TH AVE STE 326
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HATTIESBURG
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
39401-7152
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
601-288-1823
Provider Business Mailing Address Fax Number:
601-288-4360

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
128 HIGHLAND PKWY STE 202
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PICAYUNE
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39466-5578
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
601-358-9422
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/24/2020

Additional Information

Authorized Official

Authorized Official Last Name:
LOWRIMORE
Authorized Official First Name:
COURTNEY
Authorized Official Middle Name:
SHIELDS
Authorized Official Title or Position:
CONTRACT ANALYST
Authorized Official Telephone Number:
601-288-1823

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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