| Baptist Memorial Hospital-booneville, Inc. | |
|
100 Hospital St Booneville MS 38829-3354 | |
| (662) 720-5004 | |
| Not Available |
| Full Name | Baptist Memorial Hospital-booneville, Inc. |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 100 Hospital St, Booneville, Mississippi |
| Authorized Official Name and Position | Gregory M Duckett (SR VP/ CLO) |
| Authorized Official Contact | 9012275233 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Baptist Memorial Hospital-booneville, Inc. 350 N Humphreys Blvd Memphis TN 38120-2177 Ph: (901) 227-4133 | Baptist Memorial Hospital-booneville, Inc. 100 Hospital St Booneville MS 38829-3354 Ph: (662) 720-5004 |
| NPI Number | 1619934551 |
|---|---|
| Provider Enumeration Date | 04/26/2006 |
| Last Update Date | 09/30/2020 |
| Certification Date | 09/30/2020 |
| Medicare PECOS PAC ID | 7618013483 |
|---|---|
| Medicare Enrollment ID | O20091008000215 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619934551 | NPI | - | NPPES |
| 00250044 | Medicaid | TN | |
| 000020084 | Other | MS | BC PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 16161 (Mississippi) | Primary |
Region Iv Mental Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2301c East Chambers Dr, Booneville, MS 38829 Phone: 662-720-4816 Fax: 662-720-4832 | |
Region Iv Mental Health Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2100 East Chambers Drive, Booneville, MS 38829 Phone: 662-728-3174 Fax: 662-728-3175 | |
Region Iv Mental Health Services-prentiss County Children's Office Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2200 E Chambers Dr, Booneville, MS 38829 Phone: 662-728-3137 Fax: 662-728-6688 |