Provider Demographics
NPI:1184100331
Name:MS STATE VETERANS HOME OXFORD
Entity type:Organization
Organization Name:MS STATE VETERANS HOME OXFORD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:CASSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-236-7641
Mailing Address - Street 1:120 VETERANS DR
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-3578
Mailing Address - Country:US
Mailing Address - Phone:662-236-7641
Mailing Address - Fax:
Practice Address - Street 1:120 VETERANS DR
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-3578
Practice Address - Country:US
Practice Address - Phone:662-236-7641
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MS STATE VETERANS AFFAIRS BOARD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-07-11
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility