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DSH250004J NORTH MISSISSIPPI MEDICAL CENTER (Active)
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Main Details
Name
NORTH MISSISSIPPI MEDICAL CENTER
Subdivision Name
NMMC Radiation Oncology
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH250004J
Medicare Provider Number
250004
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/7/2015
Participating Start Date
1/1/2016
Participating Approval Date
10/26/2015
Last Recertification Date
8/14/2024
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
990 S. Madison St.
Tupelo, MS 38801
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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