Organization
CLARKSDALE HMA LLC
Active
Other names
Northwest Mississippi Regional Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA LALOR (DIRECTOR/DELEGATED OFFICIAL)
(615) 925-4565
Entity
Organization
Contact information
Practice address
1970 HOSPITAL DR, CLARKSDALE, MS 38614-7202
(662) 627-3211
(662) 627-5440
Mailing address
1970 HOSPITAL DR, CLARKSDALE, MS 38614-7202
(662) 624-3401
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
16035
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000020315
BLUE CROSS
MS
05
—
00220380
—
MS
Enumeration date
06/10/2006
Last updated
06/21/2019
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