Provider Demographics
NPI:1285930495
Name:PATIENTS CHOICE MEDICAL CENTER OF HUMPHREYS COUNTY, LLC
Entity type:Organization
Organization Name:PATIENTS CHOICE MEDICAL CENTER OF HUMPHREYS COUNTY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:LANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-247-3831
Mailing Address - Street 1:PO BOX 510
Mailing Address - Street 2:
Mailing Address - City:BELZONI
Mailing Address - State:MS
Mailing Address - Zip Code:39038-0510
Mailing Address - Country:US
Mailing Address - Phone:662-247-3831
Mailing Address - Fax:662-247-4114
Practice Address - Street 1:638 NORTHWEST AVE
Practice Address - Street 2:
Practice Address - City:DURANT
Practice Address - State:MS
Practice Address - Zip Code:39063-3337
Practice Address - Country:US
Practice Address - Phone:662-653-1002
Practice Address - Fax:662-653-1038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-04
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health