Provider Demographics
NPI:1619922283
Name:NATCHEZ COMMUNITY HOSPITAL LLC
Entity Type:Organization
Organization Name:NATCHEZ COMMUNITY HOSPITAL LLC
Other - Org Name:NATCHEZ COMMUNITY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLTSFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-465-7466
Mailing Address - Street 1:129 JEFFERSON DAVIS BLVD
Mailing Address - Street 2:
Mailing Address - City:NATCHEZ
Mailing Address - State:MS
Mailing Address - Zip Code:39120-5103
Mailing Address - Country:US
Mailing Address - Phone:601-445-6205
Mailing Address - Fax:601-445-6233
Practice Address - Street 1:129 JEFFERSON DAVIS BLVD
Practice Address - Street 2:
Practice Address - City:NATCHEZ
Practice Address - State:MS
Practice Address - Zip Code:39120-5103
Practice Address - Country:US
Practice Address - Phone:601-445-6205
Practice Address - Fax:601-445-6233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
275N00000X
MS12271282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS0022159Medicaid
LA1762130Medicaid
MS20639OtherBLUE CROSS MS
LA86220OtherBLUE CROSS LA
MS0022159Medicaid
LA86220OtherBLUE CROSS LA