Provider Demographics
NPI:1669349502
Name:TATE COUNTY HOSPITAL
Entity type:Organization
Organization Name:TATE COUNTY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:662-562-3191
Mailing Address - Street 1:PO BOX 508
Mailing Address - Street 2:
Mailing Address - City:SENATOBIA
Mailing Address - State:MS
Mailing Address - Zip Code:38668-0508
Mailing Address - Country:US
Mailing Address - Phone:662-612-6411
Mailing Address - Fax:662-612-6414
Practice Address - Street 1:3509 HIGHWAY 4 W
Practice Address - Street 2:
Practice Address - City:SARAH
Practice Address - State:MS
Practice Address - Zip Code:38665-3567
Practice Address - Country:US
Practice Address - Phone:662-612-6411
Practice Address - Fax:662-612-6414
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TATE COUNTY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-10-23
Last Update Date:2025-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty