Provider Demographics
NPI:1659488369
Name:BAPTIST MEMORIAL HEALTH SERVICES, INC. OF MISSISSIPPI
Entity Type:Organization
Organization Name:BAPTIST MEMORIAL HEALTH SERVICES, INC. OF MISSISSIPPI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO SENIOR VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:R
Authorized Official - Last Name:POUNDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-227-7463
Mailing Address - Street 1:350 N HUMPHREYS BLVD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-2177
Mailing Address - Country:US
Mailing Address - Phone:901-227-7463
Mailing Address - Fax:901-227-5699
Practice Address - Street 1:345 BAPTIST BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39705-2098
Practice Address - Country:US
Practice Address - Phone:662-244-4673
Practice Address - Fax:662-244-1763
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAPTIST MEMORIAL HEALTH SERVICES, INC. OF MISSISSIPPI
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-25
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS09784721Medicaid
MS09784721Medicaid
DD9956Medicare ID - Type UnspecifiedRAILROAD MEDICARE
MS09784721Medicaid