BRANDYWINE HEALTH SERVICES OF MISSISSIPPI INC NPI 1477541431

NPI Information

NPI: 1477541431
Provider Name: BRANDYWINE HEALTH SERVICES OF MISSISSIPPI, INC

Doing Business As: CHOCTAW COUNTY MEDICAL CENTER RURAL HEALTH CLINIC

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

Specialization: Rural Health

Address:
311 E CHERRY ST
ACKERMAN, MS
ZIP 39735
Phone: (662) 285-6235
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BRANDYWINE HEALTH SERVICES OF MISSISSIPPI, INC is a rural health clinic center in Ackerman, MS. BRANDYWINE HEALTH SERVICES OF MISSISSIPPI, INC NPI is 1477541431. The provider is registered as an organization entity type.
The provider Is Doing Business As Choctaw County Medical Center Rural Health Clinic.

The provider's business location address is:

311 E CHERRY ST
ACKERMAN, MS
ZIP 39735-795
Phone: (662) 285-6235
Fax: (662) 285-2516

The provider's authorized official is Ray Shoemaker .
The authorized official title is Administrator and has the following contact phone number (662) 285-6235.

The enumeration date for this NPI number is 10/12/2005 and was last updated on 7/9/2008.

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
1	261QR1300X	Clinic/Center	Rural Health		MISSISSIPPI	Yes

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
1	08479796	MEDICAID	MISSISSIPPI
2	258512	MEDICARE ID-TYPE UNSPECIFIED	MISSISSIPPI

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: 5/5/2024

NPI Synchronization or Removal

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