Provider Demographics
NPI:1639191653
Name:TIPPAH COUNTY HOSPITAL
Entity Type:Organization
Organization Name:TIPPAH COUNTY HOSPITAL
Other - Org Name:TIPPAH COUNTY HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-837-9221
Mailing Address - Street 1:PO BOX 499
Mailing Address - Street 2:
Mailing Address - City:RIPLEY
Mailing Address - State:MS
Mailing Address - Zip Code:38663-0499
Mailing Address - Country:US
Mailing Address - Phone:662-837-9221
Mailing Address - Fax:662-837-2110
Practice Address - Street 1:1005 CITY AVENUE NORTH
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:MS
Practice Address - Zip Code:38663-0499
Practice Address - Country:US
Practice Address - Phone:662-837-9221
Practice Address - Fax:662-837-2110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
367500000X
MS11-159367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS09013617Medicaid
MS09013617Medicaid