Provider Demographics
NPI:1215069018
Name:FRANKLIN COUNTY MEMORIAL HOSPITAL
Entity type:Organization
Organization Name:FRANKLIN COUNTY MEMORIAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALEDA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:DILLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-384-8112
Mailing Address - Street 1:PO BOX 636
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39653-0636
Mailing Address - Country:US
Mailing Address - Phone:601-384-8100
Mailing Address - Fax:601-384-4100
Practice Address - Street 1:40 UNION CHURCH RD
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:MS
Practice Address - Zip Code:39653-8336
Practice Address - Country:US
Practice Address - Phone:601-384-8100
Practice Address - Fax:601-384-4100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS11175282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00120619Medicaid
MS00110171Medicaid
MS00121418Medicaid
MS08602887Medicaid
MS09012397Medicaid
MS00012941Medicaid
MS000019130OtherEMERGENCY ROOM BLUE CROSS
MS00011530Medicaid
MS00120619Medicaid
MSI41852Medicare UPIN
MSB30058Medicare UPIN
MSB66044Medicare UPIN
MS09012397Medicaid
MS00012941Medicaid
MSR34836Medicare UPIN
MS00110171Medicaid
MSC00985Medicare PIN