Organization
JACKSON HMA LLC
Active
Other names
Merit Health Central
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA M LALOR (DIRECTOR/DELEGATED OFFICIAL)
(629) 215-3953
Entity
Organization
Contact information
Practice address
1850 CHADWICK DR, JACKSON, MS 39204-3404
(601) 376-1000
(601) 376-2821
Mailing address
1850 CHADWICK DR, JACKSON, MS 39204-3404
(601) 376-1000
(601) 376-2821
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
16240
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000020613
BLUE CROSS
MS
05
—
00220630
—
MS
Enumeration date
05/22/2006
Last updated
04/08/2021
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