Provider Demographics
NPI:1821420936
Name:SOUTH SUNFLOWER COUNTY HOSPITAL
Entity Type:Organization
Organization Name:SOUTH SUNFLOWER COUNTY HOSPITAL
Other - Org Name:DELTA PRIMARY CARE RURAL HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:BLESSITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-887-5235
Mailing Address - Street 1:110 E BAKER ST
Mailing Address - Street 2:
Mailing Address - City:INDIANOLA
Mailing Address - State:MS
Mailing Address - Zip Code:38751-2451
Mailing Address - Country:US
Mailing Address - Phone:662-887-5235
Mailing Address - Fax:662-887-3920
Practice Address - Street 1:110 E BAKER ST
Practice Address - Street 2:SUITE B
Practice Address - City:INDIANOLA
Practice Address - State:MS
Practice Address - Zip Code:38751-2451
Practice Address - Country:US
Practice Address - Phone:662-887-7339
Practice Address - Fax:662-887-3920
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTH SUNFLOWER COUNTY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-07-31
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QR1300X
MS11-102282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No282N00000XHospitalsGeneral Acute Care Hospital