Provider Demographics
NPI:1023140811
Name:FRANKLIN COUNTY MEMORIAL HOSPITAL
Entity type:Organization
Organization Name:FRANKLIN COUNTY MEMORIAL HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:REVENUE CYCLE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ALEDA
Authorized Official - Middle Name:J
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:601-384-8112
Mailing Address - Fax:601-384-4100
Practice Address - Street 1:595 MAIN ST E
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:MS
Practice Address - Zip Code:39653-9233
Practice Address - Country:US
Practice Address - Phone:601-387-3199
Practice Address - Fax:601-384-3950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS9013856Medicaid
MS=========OtherGROUP BLUE CROSS MS ID
MS9013856Medicaid