Provider Demographics
NPI:1922319672
Name:LEFLORE COUNTY HEALTH CENTER
Entity Type:Organization
Organization Name:LEFLORE COUNTY HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:T
Authorized Official - Last Name:HIBBLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-459-2629
Mailing Address - Street 1:PO BOX 9667
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:38930-8667
Mailing Address - Country:US
Mailing Address - Phone:662-459-2183
Mailing Address - Fax:662-459-2184
Practice Address - Street 1:706 HIGHWAY 82 W
Practice Address - Street 2:SUITE A
Practice Address - City:GREENWOOD
Practice Address - State:MS
Practice Address - Zip Code:38930-5028
Practice Address - Country:US
Practice Address - Phone:662-459-2183
Practice Address - Fax:662-459-2184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-28
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center