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Organization

STATE OF MISSISSIPPI - UNIVERSITY OF MISSISSIPPI MEDICAL CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JEFFREY GRIMSLEY (ASSOCIATE CFO-CLINICAL OPERATIONS)
(601) 815-6270
Entity
Organization

Contact information

Practice address
2500 N STATE ST, JACKSON, MS 39216
(601) 984-1000
(601) 815-0434
Mailing address
PO BOX 11407, BIRMINGHAM, AL 35246-2130
(601) 984-1000

Taxonomy

Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
11-199
MS
282N00000X
General Acute Care Hospital
341600000X
Ambulance

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000020149
STATE OF MS
MS
05
00020149
MS
05
00075205
MS
05
00550462
MS
05
009908195
AK
05
0104140
DC
05
05375086
MS
05
1000022942
DE
05
100510031
NV
05
10672004
MO
05
108481105
AR
05
1154317527
MI
05
1185270
NV
05
1430321
KY
05
1691529
NY
05
1731200
LA
05
18204400002
PA
05
188845
OH
05
200125970A
IN
05
2314400
ID
05
23487232
CO
05
2500001
NC
05
250001
TN
05
372079
AZ
05
908079
IA
01
=========
AETNA
MS
05
=========
IL
05
HOS1149N
AL
05
HS022IP
AK
05
HS022OP
AK
05
XHSP32759
CA
05
XHSP42759
CA
Enumeration date
09/21/2005
Last updated
01/23/2025
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