Provider Demographics
NPI:1942969746
Name:NORTH MISSISSIPPI PRIMARY HEALTH CARE, INC.
Entity Type:Organization
Organization Name:NORTH MISSISSIPPI PRIMARY HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:G
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-224-8951
Mailing Address - Street 1:PO BOX 92
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:MS
Mailing Address - Zip Code:38603-0092
Mailing Address - Country:US
Mailing Address - Phone:662-502-3137
Mailing Address - Fax:662-224-6801
Practice Address - Street 1:521 MAIN STREET
Practice Address - Street 2:
Practice Address - City:WALNUT
Practice Address - State:MS
Practice Address - Zip Code:38683-9394
Practice Address - Country:US
Practice Address - Phone:662-223-4011
Practice Address - Fax:662-224-6801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-09
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty