Provider Demographics
NPI:1891966545
Name:NORTH OAK HOSPITAL, INC
Entity Type:Organization
Organization Name:NORTH OAK HOSPITAL, INC
Other - Org Name:NORTH OAK REGIONAL MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAM
Authorized Official - Middle Name:
Authorized Official - Last Name:AYERS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:662-562-3100
Mailing Address - Street 1:401 GETWELL DR
Mailing Address - Street 2:
Mailing Address - City:SENATOBIA
Mailing Address - State:MS
Mailing Address - Zip Code:38668-2213
Mailing Address - Country:US
Mailing Address - Phone:662-562-3100
Mailing Address - Fax:
Practice Address - Street 1:401 GETWELL DR
Practice Address - Street 2:
Practice Address - City:SENATOBIA
Practice Address - State:MS
Practice Address - Zip Code:38668-2213
Practice Address - Country:US
Practice Address - Phone:662-562-3100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM2500X
MS16-286282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS09013407Medicaid