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Organization

BRANDON HMA LLC

Active
Other names
Crossgates River Oaks Hospital
Organization subpart
No

Provider details

NPI number
Authorized official
TIMOTHY PARRY ESQ (SR. VP AND GENERAL COUNSEL)
(239) 598-3176
Entity
Organization

Contact information

Practice address
350 CROSSGATES BLVD, BRANDON, MS 39042-2601
(601) 824-8583
Mailing address
350 CROSSGATES BLVD, BRANDON, MS 39042-2601
(601) 824-8583

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
207RP1001X
Pulmonary Disease Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000019303
BLUE CROSS
MS
05
06638595
MS
Enumeration date
05/23/2007
Last updated
03/22/2010
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