Provider Demographics
NPI:1093532889
Name:RH EMERGENCY MEDICINE OF OCH REGIONAL LLC
Entity type:Organization
Organization Name:RH EMERGENCY MEDICINE OF OCH REGIONAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ENTERPRISE CFO
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:WAKEFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-901-5103
Mailing Address - Street 1:PO BOX 7058
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38802-7058
Mailing Address - Country:US
Mailing Address - Phone:662-432-4106
Mailing Address - Fax:
Practice Address - Street 1:400 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:STARKVILLE
Practice Address - State:MS
Practice Address - Zip Code:39759-2163
Practice Address - Country:US
Practice Address - Phone:662-432-4106
Practice Address - Fax:833-740-3625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-23
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty