Provider Demographics
NPI:1669705612
Name:FRANKLIN COUNTY MEMORIAL HOSPITAL
Entity type:Organization
Organization Name:FRANKLIN COUNTY MEMORIAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE DIRECTOR
Authorized Official - Prefix:MRS
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:601-384-5801
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:601-384-8112
Practice Address - Fax:601-384-4100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-09
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS11175282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00020130Medicaid
MS000020130OtherBLUE CROSS BLUE SHIELD
MS000020130OtherBLUE CROSS BLUE SHIELD