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Organization

MS BAND OF CHOCTAW INDIANS

Active
Other names
DBA CHOCTAW HEALTH CENTER WOMEN'S WELLNESS
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. PHYLLIS J ANDERSON (TRIBAL CHIEF)
(601) 656-2211
Entity
Organization

Contact information

Practice address
210 HOSPITAL CIR, CHOCTAW, MS 39350-6781
(601) 656-2211
(601) 663-7721
Mailing address
210 HOSPITAL CIR, CHOCTAW, MS 39350-6781
(601) 656-2211
(601) 663-7721

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
09013321
MS
Enumeration date
02/16/2010
Last updated
06/15/2012
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