Provider Demographics
NPI:1457666083
Name:CHOCTAW COUNTY
Entity Type:Organization
Organization Name:CHOCTAW COUNTY
Other - Org Name:CHOCTAW COUNTY- ER
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT OF THE BOARD
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:F
Authorized Official - Last Name:HIGGINS
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:662-285-6329
Mailing Address - Street 1:311 W CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:ACKERMAN
Mailing Address - State:MS
Mailing Address - Zip Code:39735-8708
Mailing Address - Country:US
Mailing Address - Phone:601-849-1682
Mailing Address - Fax:601-849-1969
Practice Address - Street 1:311 W CHERRY ST
Practice Address - Street 2:
Practice Address - City:ACKERMAN
Practice Address - State:MS
Practice Address - Zip Code:39735-8708
Practice Address - Country:US
Practice Address - Phone:601-849-1682
Practice Address - Fax:601-849-1969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-06
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care