Organization
DUGAN MEMORIAL HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TAMMY SHEA MARTIN ADMINISTRATOR (EXECUTIVE DIRECTOR)
(662) 494-3640
Entity
Organization
Contact information
Practice address
804 E MAIN ST, WEST POINT, MS 39773-3137
(662) 494-3640
(662) 494-3641
Mailing address
PO BOX 698, WEST POINT, MS 39773-0698
(662) 494-3640
(662) 494-3641
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
178
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
25A411
—
MS
Enumeration date
10/05/2005
Last updated
08/22/2020
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