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DSH250004S NORTH MISSISSIPPI MEDICAL CENTER (Active)
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Main Details
Name
NORTH MISSISSIPPI MEDICAL CENTER
Subdivision Name
dba NMMC Womens Center-Short Stay Surgery - Short Stay Surgery
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH250004S
Medicare Provider Number
250004
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/17/2018
Participating Start Date
10/1/2018
Participating Approval Date
7/19/2018
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
4566 South Eason Blvd
Tupelo, MS 38801
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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