1750826327 NPI number — HINDS STREET BAPTIST CHURCH

Table of content: (NPI 1750826327)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750826327 NPI number — HINDS STREET BAPTIST CHURCH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HINDS STREET BAPTIST CHURCH
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:
HINDS ST. CHURCH CDC ADULT DAY CARE CENTER
Provider Other Organization Name Type Code:
3
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:
1750826327
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/05/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1588
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENVILLE
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
38702-1588
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
662-332-0804
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
448 N HINDS ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENVILLE
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
38701-2928
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
662-332-0804
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/05/2017

Additional Information

Authorized Official

Authorized Official Last Name:
ARMSTRONG
Authorized Official First Name:
OLLIE
Authorized Official Middle Name:
M
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
662-347-4873

Provider Taxonomy Codes

  • Taxonomy code: 261QA0600X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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