GREENWOOD LEFLORE HOSPITAL NPI 1003875394

NPI Information

  • NPI: 1003875394
  • Provider Name: GREENWOOD LEFLORE HOSPITAL
  • Classification: Clinic/Center - 261QR1300X
  • Specialization: Rural Health
  • Entity Type: Organization
  • Doing Business As: ITTA BENA CLINIC
  • CLIA Number: 25D0888439
  • Address: 103 BASKET ST
    ITTA BENA, MS
    ZIP 38941
  • Phone: (662) 254-7801

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NPI Details

GREENWOOD LEFLORE HOSPITAL is a rural health clinic center in Itta Bena, MS. GREENWOOD LEFLORE HOSPITAL NPI is 1003875394. The provider is registered as an organization entity type.
The provider Is Doing Business As Itta Bena Clinic.

The provider's business location address is:

103 BASKET ST
ITTA BENA, MS
ZIP 38941-801
Phone: (662) 254-7801

The provider's authorized official is Jennifer Dawne Holmes .
The authorized official title is Cfo and has the following contact phone number (662) 459-2603.

The CLIA number assigned to this NPI record is 25D0888439 - rural health clinic with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 3/23/2006 and was last updated on 5/7/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QR1300XClinic/CenterRural HealthYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
109014635MEDICAIDMISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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