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Organization

MISSISSIPPI BAND OF CHOCTAW INDIANS

Active
Parent organization
MISSISSIPPI BAND OF CHOCTAW INDIANS
Other names
RED WATER SATELLITE CLINIC
Organization subpart
Yes

Provider details

NPI number
Legal business name
MISSISSIPPI BAND OF CHOCTAW INDIANS
Authorized official
MRS. PHYLLIS J ANDERSON (TRIBAL CHIEF)
(601) 656-2211
Entity
Organization

Contact information

Practice address
1930 N PEARL ST, CARTHAGE, MS 39051-8220
(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
261QP0904X
Federal Public Health Clinic/Center
Primary

Other

Enumeration date
11/02/2006
Last updated
06/15/2012
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