| |
977 Emergency Dr West Point MS 39773-9322 | |
(662) 494-5232 | |
(662) 494-1211 |
Full Name | |
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Speciality | Clinic/Center |
Location | 977 Emergency Dr, West Point, Mississippi |
Authorized Official Name and Position | Bruce J Toppin (CORPORATE SECRETARY) |
Authorized Official Contact | 6623774229 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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808 Varsity Dr Tupelo MS 38801-4613 Ph: (662) 377-2774 | 977 Emergency Dr West Point MS 39773-9322 Ph: (662) 494-5232 |
NPI Number | 1508224312 |
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Provider Enumeration Date | 02/08/2016 |
Last Update Date | 01/20/2025 |
Medicare PECOS PAC ID | 4789649609 |
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Medicare Enrollment ID | O20161014000856 |
Identifier | Type | State | Issuer |
---|---|---|---|
1508224312 | NPI | - | NPPES |
355782 | Other | MS | MEDICARE |
000427062 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | 13-312 (Mississippi) | Primary |
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