Provider Demographics
NPI:1427392919
Name:NORTH MISSISSIPPI MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:NORTH MISSISSIPPI MEDICAL CENTER, INC.
Other - Org Name:NMMC INPATIENT HOSPICE UNIT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:REPPERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-377-3978
Mailing Address - Street 1:422A E PRESIDENT AVE
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-5500
Mailing Address - Country:US
Mailing Address - Phone:662-377-3612
Mailing Address - Fax:
Practice Address - Street 1:830 S GLOSTER ST
Practice Address - Street 2:5 SOUTH
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-4934
Practice Address - Country:US
Practice Address - Phone:662-377-3612
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-21
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00070662Medicaid
MS251501Medicare Oscar/Certification