Provider Demographics
NPI:1578019154
Name:NORTH MISSISSIPPI MEDICAL CENTER INC.
Entity Type:Organization
Organization Name:NORTH MISSISSIPPI MEDICAL CENTER INC.
Other - Org Name:CHILDREN'S CLINIC SALTILLO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:TOPPIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-377-3000
Mailing Address - Street 1:108 DESERT COVE
Mailing Address - Street 2:
Mailing Address - City:SALTILLO
Mailing Address - State:MS
Mailing Address - Zip Code:38866
Mailing Address - Country:US
Mailing Address - Phone:662-844-9885
Mailing Address - Fax:662-869-1595
Practice Address - Street 1:108 DESERT COVE
Practice Address - Street 2:
Practice Address - City:SALTILLO
Practice Address - State:MS
Practice Address - Zip Code:38866
Practice Address - Country:US
Practice Address - Phone:662-844-9885
Practice Address - Fax:662-869-1595
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTH MISSISSIPPI HEALTH SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-09-01
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS396384Medicare PIN