Provider Demographics
NPI:1548581184
Name:NORTH SUNFLOWER MEDICAL CENTER
Entity Type:Organization
Organization Name:NORTH SUNFLOWER MEDICAL CENTER
Other - Org Name:SUNFLOWER DIAGNOSTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:CEJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-756-2711
Mailing Address - Street 1:101 FLOYCE ST.
Mailing Address - Street 2:
Mailing Address - City:RULEVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38771
Mailing Address - Country:US
Mailing Address - Phone:662-756-2100
Mailing Address - Fax:
Practice Address - Street 1:101 FLOYCE ST.
Practice Address - Street 2:
Practice Address - City:RULEVILLE
Practice Address - State:MS
Practice Address - Zip Code:38771
Practice Address - Country:US
Practice Address - Phone:662-756-2100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-17
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS11-168261QR0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mammography