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Organization

MISSISSIPPI BAND OF CHOCTAW INDIANS

Active
Parent organization
MISSISSIPPI BAND OF CHOCTAW INDIANS
Other names
CHOCTAW HEALTH CENTER AMBULANCE
Organization subpart
Yes

Provider details

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

Contact information

Practice address
210 HOSPITAL CIRCLE, CHOCTAW, MS 39350-6781
(601) 656-2211
(601) 663-7721
Mailing address
210 HOSPITAL CIRCLE, CHOCTAW, MS 39350-6781
(601) 656-2211
(601) 663-7721

Taxonomy

Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
025
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00050014
MS
Enumeration date
10/10/2006
Last updated
06/14/2012
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