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DSH250067E CLAY COUNTY MEDICAL CORPORATION (Active)
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Main Details
Name
CLAY COUNTY MEDICAL CORPORATION
Subdivision Name
CLAY COUNTY MEDICAL CORPORATION - West Point Internal Medicine Clinic PA-RHC
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH250067E
Medicare Provider Number
250067
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/9/2020
Participating Start Date
7/1/2020
Participating Approval Date
5/22/2020
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
977 EMERGENCY DR
CLAY COUNTY MEDICAL CENTER
WEST POINT, MS 39773-9322
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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