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Organization

MISSISSIPPI STATE UNIVERSITY

Active
Parent organization
MISSISSIPPI STATE UNIVERSITY
Other names
John C Longest Student Health Center
Organization subpart
Yes

Provider details

NPI number
Legal business name
MISSISSIPPI STATE UNIVERSITY
Authorized official
DANIEL T HALE (CLINIC BUSINESS ADMINISTRATOR)
(662) 325-5895
Entity
Organization

Contact information

Practice address
360 HARDY RD, MISSISSIPPI STATE, MS 39762
(662) 325-2431
(662) 325-8888
Mailing address
PO BOX 6338, MISSISSIPPI STATE, MS 39762-6338
(662) 325-2431
(662) 325-8888

Taxonomy

Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
09012379
MS
Enumeration date
12/02/2005
Last updated
01/09/2026
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