| Organization Name: | PONTOTOC HEALTH SERVICES, INC. |
| NPI Number: | 1053728139 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOSEPH A REPPERT (CFO) |
| Mailing Address: | 202 Main St Ecru |
| State: | MS US |
| Postal Code: | 388419604 |
| Phone Number: | 6624894345 |
| Fax Number: | |
| NPI Enumeration Date: | 07/21/2014 |
| NPI Last Update Date: | 09/03/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | 16091 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |