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CAH251308-00 PONTOTOC HEALTH SERVICES (Active)
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Main Details
Name
PONTOTOC HEALTH SERVICES
Subdivision Name
PONTOTOC HEALTH SERVICES
Type
Critical Access Hospital
Rural
No
340B ID
CAH251308-00
Medicare Provider Number
251308
Additional Details
Current Program Status
Active
Registration Date
10/9/2014
Participating Start Date
1/1/2015
Participating Approval Date
12/11/2014
Last Recertification Date
9/6/2024
Contacts
Authorizing Official
North Mississippi Medical Center
BRUCE J. TOPPIN, GENERAL COUNSEL, PRIVACY OFFICER & COPORATE SECRETARY
(662) 377-4229
Primary Contact
North Mississippi Medical Center
Patti Hawkins, Director
(662) 377-4731
Addresses
Street Address
176 SOUTH MAIN
PONTOTOC, MS 38863
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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