Organization
NORTH MISSISSIPPI PRIMARY HEALTH CARE, INC.
Active
Parent organization
NORTH MISSISSIPPI PRIMARY HEALTH CARE, INC.
Other names
WALNUT MEDICAL CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTH MISSISSIPPI PRIMARY HEALTH CARE, INC.
Authorized official
JAMES D NUNNALLY (CEO)
(662) 224-8951
Entity
Organization
Contact information
Practice address
531 MAIN ST, WALNUT, MS 38683-9349
(662) 223-4011
(662) 223-4018
Mailing address
15921 BOUNDARY DR, PO BOX 92, ASHLAND, MS 38603-7740
(662) 224-8951
(662) 224-6801
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09011971
—
MS
Enumeration date
04/02/2015
Last updated
05/07/2015
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