Mississippi State Department of Health

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

10081 Issued in MS

Legal business name

MISSISSIPPI STATE DEPARTMENT OF HEALTH

Doing business as

East Central Home Health Agency 6A

Practice address

2071 Magnolia Office Park
Highway 35 S
Forest, MS 39074-0150

Phone

(601) 469-3043

Fax

(601) 469-2996

NPI assigned

Nov 29, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Melanie Bowman, RN

Title

Director of Home Health

Phone

(601) 576-7853

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• East Central Home Health Agency 6A Doing business as

Locations

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

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216080000000",
    "number": "1952384471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 150",
            "address_2": "2071 MAGNOLIA OFFICE PARK",
            "city": "FOREST",
            "state": "MS",
            "postal_code": "390740150",
            "telephone_number": "601-469-3043",
            "fax_number": "601-469-2996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2071 MAGNOLIA OFFICE PARK",
            "address_2": "HIGHWAY 35 S",
            "city": "FOREST",
            "state": "MS",
            "postal_code": "390740150",
            "telephone_number": "601-469-3043",
            "fax_number": "601-469-2996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSISSIPPI STATE DEPARTMENT OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-29",
        "last_updated": "2008-07-15",
        "status": "A",
        "authorized_official_last_name": "BOWMAN",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_title_or_position": "DIRECTOR OF HOME HEALTH",
        "authorized_official_telephone_number": "601-576-7853",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MS",
            "license": "10081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00070500",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Central Home Health Agency 6A",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Agency in Forest, MS
• Providers in Forest, MS by specialty
• Home Health Agency in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.