Provider Demographics
NPI:1346084985
Name:TYLER HOLMES MEMORIAL HOSPITAL
Entity type:Organization
Organization Name:TYLER HOLMES MEMORIAL HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CORI
Authorized Official - Middle Name:H
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-283-4114
Mailing Address - Street 1:409 TYLER HOLMES DR
Mailing Address - Street 2:
Mailing Address - City:WINONA
Mailing Address - State:MS
Mailing Address - Zip Code:38967-1521
Mailing Address - Country:US
Mailing Address - Phone:662-283-4114
Mailing Address - Fax:662-283-6125
Practice Address - Street 1:400 LAMAR AVE
Practice Address - Street 2:
Practice Address - City:KILMICHAEL
Practice Address - State:MS
Practice Address - Zip Code:39747-9780
Practice Address - Country:US
Practice Address - Phone:662-283-4114
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TYLER HOLMES MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-06-19
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Multi-Specialty