| Organization Name: | BRANDYWINE HEALTH SERVICES OF MISSISSIPPI, INC |
| NPI Number: | 1356339576 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RAY SHOEMAKER (CEO) |
| Mailing Address: | 311 West Cherry Street Ackerman |
| State: | MS US |
| Postal Code: | 39735 |
| Phone Number: | 6622856235 |
| Fax Number: | 6622852516 |
| NPI Enumeration Date: | 10/11/2005 |
| NPI Last Update Date: | 07/09/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 282NC0060X |
| License Number: | 16191 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Hospitals |
| Taxonomy Classification: | General Acute Care Hospital |
| Taxonomy Specialization: | Critical Access |
| Taxonomy Definition: | |