Provider Demographics
NPI:1346973625
Name:QUITMAN COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:QUITMAN COMMUNITY HOSPITAL
Other - Org Name:QUITMAN FAMILY & SPECIALTY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:CONWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-357-3883
Mailing Address - Street 1:340 GETWELL ST
Mailing Address - Street 2:
Mailing Address - City:MARKS
Mailing Address - State:MS
Mailing Address - Zip Code:38646-9785
Mailing Address - Country:US
Mailing Address - Phone:662-388-0700
Mailing Address - Fax:662-388-0707
Practice Address - Street 1:340 GETWELL ST
Practice Address - Street 2:
Practice Address - City:MARKS
Practice Address - State:MS
Practice Address - Zip Code:38646-9785
Practice Address - Country:US
Practice Address - Phone:662-388-0700
Practice Address - Fax:662-388-0707
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:QUITMAN COMMUNITY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-07-05
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty