# RUSH MEDICAL FOUNDATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Professional Services Division
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588625594
- **Authorized official:** MR. DON LARKIN KENNEDY (REGIONAL CEO)
- **Authorized official phone:** (601) 703-9614

## Contact information

- **Practice address:** 1314 19TH AVE, MERIDIAN, MS 39301-4116
- **Practice address phone:** (601) 483-0011
- **Practice address fax:** (601) 703-3080
- **Mailing address:** DEPT 3024 P O BOX 1000, MEMPHIS, TN 38148-3024
- **Mailing address phone:** (601) 213-3010
- **Mailing address fax:** (601) 213-3011

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |
| 2080P0202X | Pediatric Cardiology Physician | — | NULL | — |
| 2080P0202X | Pediatric Cardiology Physician | — | — | — |
| 367500000X | Certified Registered Nurse Anesthetist | — | NULL | — |
| 367500000X | Certified Registered Nurse Anesthetist | — | — | — |

## Other

- **Enumeration date:** 03/29/2006
- **Last updated:** 12/28/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 009014336 | — | MS |