NPIMap

Organization Active NPI

Quitman Community Hospital

Doing business as Quitman County Ambulance Service

  • Ambulance
  • Marks, MS
National Provider Identifier
1184356602
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
Legal business name
QUITMAN COMMUNITY HOSPITAL
Doing business as
Quitman County Ambulance Service
Practice address
340 Getwell St
Marks, MS 38646-9785
Phone
(662) 388-0700
Fax
(662) 388-0707
NPI assigned
Jun 24, 2022
Last updated
Oct 25, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
QUITMAN COMMUNITY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lester Andrew Wilkinson
Title
Cfo
Phone
(662) 934-3900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X Primary

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 names 1

  • Quitman County Ambulance Service Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221212001573 MS Part B Supplier - Ambulance Service Supplier 7012306830 Practice locations: Marks, MS

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Quitman Community Hospital6 organizations share this tax ID, including this one
Part of
Quitman Community Hospital

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

340 Getwell St
Marks, MS 38646
Phone (662) 326-8031

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Quitman Community HospitalMarks, MS, CCN 251339 Hospital 5% Or Greater Direct Ownership Interest (100%) May 24, 2022
Quitman Community Senior CareMarks, MS, CCN 25M339 Hospital 5% Or Greater Direct Ownership Interest (100%) Sep 17, 2021

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1656028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666656000000",
    "number": "1184356602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 GETWELL ST",
            "city": "MARKS",
            "state": "MS",
            "postal_code": "386469785",
            "telephone_number": "662-388-0700",
            "fax_number": "662-388-0707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 GETWELL ST",
            "city": "MARKS",
            "state": "MS",
            "postal_code": "386469785",
            "telephone_number": "662-388-0700",
            "fax_number": "662-388-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUITMAN COMMUNITY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "QUITMAN COMMUNITY HOSPITAL",
        "enumeration_date": "2022-06-24",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A",
        "authorized_official_last_name": "WILKINSON",
        "authorized_official_first_name": "LESTER",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "662-934-3900"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Quitman County Ambulance Service",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Quitman County Ambulance Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marks, MS

Sources for this page

Verify at the official NPI Registry.