Provider Demographics
NPI:1730645243
Name:METHODIST OF MISSISSIPPI HOSPITAL & REHABILITATION CENTER
Entity Type:Organization
Organization Name:METHODIST OF MISSISSIPPI HOSPITAL & REHABILITATION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:ARMSTRONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-364-3360
Mailing Address - Street 1:1350 E WOODROW WILSON AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216
Mailing Address - Country:US
Mailing Address - Phone:601-936-8899
Mailing Address - Fax:
Practice Address - Street 1:101 G T THAMES DR
Practice Address - Street 2:
Practice Address - City:STARKVILLE
Practice Address - State:MS
Practice Address - Zip Code:39759
Practice Address - Country:US
Practice Address - Phone:662-615-6133
Practice Address - Fax:662-615-6143
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:METHODIST OF MISSISSIPPI HOSPITAL & REHABILITATION CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-02-20
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies