Quitman Community Hospital
Organization Active NPI Ambulance · Marks, MS
NPI 1184356602 · NPPES record last updated Oct 25, 2022
Key facts
- NPI
- 1184356602
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulance 341600000X
- Legal business name
- QUITMAN COMMUNITY HOSPITAL
- Practice address
- 340 Getwell St
Marks, MS 38646-9785 - Phone
- (662) 388-0700
- Fax
- (662) 388-0707
- NPI assigned
- Jun 24, 2022
- Organization subpart
- Yes
- Parent organization (as reported)
- QUITMAN COMMUNITY HOSPITAL
Authorized official
- Name
- Lester Andrew Wilkinson
- Title
- Cfo
- Phone
- (662) 934-3900
Owned or controlled facilities with NPI records 2
Other NPIs with the same Medicare PAC ID 2
Corporate family (same tax ID) 5
Member organizations 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| Quitman Community Hospital |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | May 24, 2022 |
| Quitman Community Senior Care |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Sep 17, 2021 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20221212001573 | MS | Part B Supplier - Ambulance Service Supplier | 7012306830 | Practice locations: Marks, MS |
National Provider Directory
- Tax ID family
- Quitman Community Hospital
- Part of
- Quitman Community Hospital
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | Yes |
Addresses
Primary practice location
340 Getwell St
Marks, MS 38646-9785
Mailing address
340 Getwell St
Marks, MS 38646-9785
Phone (662) 388-0700
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02755745 | Medicaid | MS |
Other names
- Quitman County Ambulance Service
Other providers in Marks, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 25, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.