Provider Demographics
NPI:1164422580
Name:MISSISSIPPI UNIVERSITY FOR WOMEN
Entity Type:Organization
Organization Name:MISSISSIPPI UNIVERSITY FOR WOMEN
Other - Org Name:MUW SPEECH & HEARING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INTERIM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:TOWNSEND
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC SLP
Authorized Official - Phone:662-329-7270
Mailing Address - Street 1:1100 COLLEGE ST
Mailing Address - Street 2:MUW-1340
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39701-5800
Mailing Address - Country:US
Mailing Address - Phone:662-329-7270
Mailing Address - Fax:662-329-7460
Practice Address - Street 1:620 10TH ST SOUTH
Practice Address - Street 2:CROMWELL BLDG ROOM 129
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39701
Practice Address - Country:US
Practice Address - Phone:662-329-7270
Practice Address - Fax:662-329-7460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-28
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS09014446Medicaid