Provider Demographics
NPI:1295866168
Name:FRANKLIN COUNTY MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:FRANKLIN COUNTY MEMORIAL HOSPITAL
Other - Org Name:MEADVILLE MEDICAL CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:BUSINESS OFFICE/REV CYCLE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALEDA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:DILLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-384-8112
Mailing Address - Street 1:PO BOX 428
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39653-0428
Mailing Address - Country:US
Mailing Address - Phone:601-384-2396
Mailing Address - Fax:601-384-3648
Practice Address - Street 1:115B HIGHWAY 556
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:MS
Practice Address - Zip Code:39653
Practice Address - Country:US
Practice Address - Phone:601-384-2396
Practice Address - Fax:601-384-3648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSI8292261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS09221795Medicaid
MS09221795Medicaid
MS3021508488Medicare Oscar/Certification
MSC03414Medicare ID - Type UnspecifiedCAHABA PART B MEDICARE
MS09221795Medicaid