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FIELD MEMORIAL COMMUNITY HOSPITAL NPI 1134166812


NPI Information

NPI: 1134166812
Provider Name: FIELD MEMORIAL COMMUNITY HOSPITAL

Doing Business As: CENTREVILLE CLINIC

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

CLIA Number: 25D0320005

Address:
178 HIGHWAY 24 E STE A
CENTREVILLE, MS
ZIP 39631
Phone: (601) 890-0520
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FIELD MEMORIAL COMMUNITY HOSPITAL is a rural health clinic center in Centreville, MS. FIELD MEMORIAL COMMUNITY HOSPITAL NPI is 1134166812. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Centreville Clinic.

The provider's business location address is:

178 HIGHWAY 24 E STE A
CENTREVILLE, MS
ZIP 39631-171
Phone: (601) 890-0520
Fax: (601) 645-5088

The provider's authorized official is Jeremy Chad Netterville .
The authorized official title is Administrator and has the following contact phone number (601) 890-0545.

The CLIA number assigned to this NPI record is 25D0320005 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/1/2006 and was last updated on 9/12/2019.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal MedicineNo
2208600000XSurgeryNo
3261QR1300XClinic/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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11444669MEDICAIDLOUISIANA
209016302MEDICAIDMISSISSIPPI
3C02787OTHERCAHABA

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: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.