Organization Name: | PONTOTOC HEALTH SERVICES, INC. |
NPI Number: | 1538576772 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOSEPH A REPPERT (CFO) |
Mailing Address: | 345 Highway 15 N Pontotoc |
State: | MS US |
Postal Code: | 388631105 |
Phone Number: | 6624897430 |
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: |