HUDSPETH CENTER PHARMACY
Intermediate Care Facility, Mentally Retarded
Whitfield, Mississippi
Provider NPI: 1346234184
Organization Information:Organization Name: HUDSPETH CENTER PHARMACY
Practice Location:
HIGHWAY 475 WHITFIELD, MS 39193 US
Tel: 601-664-6352 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
HIGHWAY 475 WHITFIELD, MS 39193 US
Tel: 601-664-6352 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 315P00000X | Nursing & Custodial Care Facilities Intermediate Care Facility, Mentally Retarded | MS | 01343/03.1 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
00095184 | MS | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin