Provider Demographics
NPI:1982191367
Name:BOA VIDA HOSPITAL OF ABERDEEN, MS, LLC
Entity Type:Organization
Organization Name:BOA VIDA HOSPITAL OF ABERDEEN, MS, LLC
Other - Org Name:MRH MEDICAL GROUP, CORINTH
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KIRNJOT
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-339-7339
Mailing Address - Street 1:10996 FOUR SEASONS PL STE 100A
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-8685
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:815 CHILDS ST
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:MS
Practice Address - Zip Code:38834
Practice Address - Country:US
Practice Address - Phone:662-369-2455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BOA VIDA HOSPITAL OF ABERDEEN, MS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-04-20
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health