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Organization
TISHOMINGO HEALTH SERVICES, INC.
Active
Organization
TISHOMINGO HEALTH SERVICES, INC.
Active
Parent organization
TISHOMINGO HEALTH SERVICES, INC.
Other names
Tishomingo Co Hospital
Organization subpart
Yes
Provider details
NPI number
Legal business name
TISHOMINGO HEALTH SERVICES, INC.
Authorized official
MR. JOSEPH A REPPERT (CFO)
(662) 377-3978
Entity
Organization
Contact information
Practice address
1777 CURTIS DR, IUKA, MS 38852
(662) 423-4074
(662) 423-4550
Mailing address
1777 CURTIS DR, IUKA, MS 38852
(662) 423-4074
(662) 423-4550
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
13-221
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00000121917
—
TN
01
—
000020169
BLUE CROSS
MS
05
—
0020393
—
MS
01
—
010-075
BLUE CROSS
AL
01
—
104781
BLUE CROSS
TN
05
—
HOS0002P
—
AL
Enumeration date
08/21/2006
Last updated
11/11/2011
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