Organization
BRANDON HMA LLC
Active
Other names
Merit Health Rankin
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA M LALOR (DIRECTOR/DELEGATED OFFICIAL)
(629) 215-3953
Entity
Organization
Contact information
Practice address
350 CROSSGATES BLVD, BRANDON, MS 39042-2601
(601) 824-8501
(601) 824-8530
Mailing address
350 CROSSGATES BLVD, BRANDON, MS 39042-2601
(601) 824-8501
(601) 824-8530
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
16250
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00220417
—
MS
01
—
20303
BLUE CROSS
MS
Enumeration date
05/26/2006
Last updated
03/29/2021
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