| Greenwood Leflore Hospital | |
|
103 Basket St Itta Bena MS 38941-2801 | |
| (662) 254-7801 | |
| Not Available |
| Full Name | Greenwood Leflore Hospital |
|---|---|
| Speciality | Clinic/Center |
| Location | 103 Basket St, Itta Bena, Mississippi |
| Authorized Official Name and Position | Jennifer Dawne Holmes (CFO) |
| Authorized Official Contact | 6624592603 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Greenwood Leflore Hospital Po Box 1410 Greenwood MS 38935-1410 Ph: (662) 254-7801 | Greenwood Leflore Hospital 103 Basket St Itta Bena MS 38941-2801 Ph: (662) 254-7801 |
| NPI Number | 1003875394 |
|---|---|
| Provider Enumeration Date | 03/23/2006 |
| Last Update Date | 05/07/2018 |
| Medicare PECOS PAC ID | 1153399472 |
|---|---|
| Medicare Enrollment ID | O20091117000491 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003875394 | NPI | - | NPPES |
| 09014635 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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