| Organization Name: | INDEPENDENT HEALTHCARE MANAGEMENT, INC. |
| NPI Number: | 1255376729 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOSEPH S MCNULTY (PRESIDENT) |
| Mailing Address: | 330 N Broad St Forest |
| State: | MS US |
| Postal Code: | 390743508 |
| Phone Number: | 6014694771 |
| Fax Number: | 6014694724 |
| NPI Enumeration Date: | 06/18/2006 |
| NPI Last Update Date: | 06/19/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |