Provider Demographics
NPI:1609322205
Name:TALLAHATCHIE GENERAL HOSPITAL
Entity Type:Organization
Organization Name:TALLAHATCHIE GENERAL HOSPITAL
Other - Org Name:TUTWILER CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:RENE
Authorized Official - Last Name:VEST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-625-7111
Mailing Address - Street 1:PO BOX 230
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:MS
Mailing Address - Zip Code:38921-0240
Mailing Address - Country:US
Mailing Address - Phone:662-647-5535
Mailing Address - Fax:662-647-5392
Practice Address - Street 1:205 ALMA ST
Practice Address - Street 2:
Practice Address - City:TUTWILER
Practice Address - State:MS
Practice Address - Zip Code:38963-5067
Practice Address - Country:US
Practice Address - Phone:662-345-8334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health