MISSISSIPPI STATE DEPARTMENT OF HEALTH (NPI# 1366853004) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366853004 |
| Entity Type | Organization |
| Organization Name | MISSISSIPPI STATE DEPARTMENT OF HEALTH |
| Other Organization Name | SOUTH JACKSON WIC DISTRIBUTION |
| Practice Address |
3276 Lynch St Jackson MS 39209-7205 |
| Mailing Address |
570 E Woodrow Wilson Ave Jackson MS 39216-4538 |
| Practice Telephone | 6019695730 |
| Practice Fax Number | 6019695729 |
| Mailing Telephone | 6015767635 |
| Enumeration Date | 2014-05-15 |
| Last Update Date | 2014-05-15 |
| Authorized Official Name | MR. MITCHELL ADCOCK (CHIEF ADMINISTRATIVE OFFICER) |
| Authorized Official Telephone | 6015767635 |
| Authorized Official Credential | CAO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251K00000X | Public Health or Welfare | Agencies |
| Other Name | Type Code |
|---|---|
| South Jackson WIC Distribution | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316358914 | Mississippi State Department of Health | Public Health or Welfare | 110 Cross Park Dr, Suite C, Pearl, MS 39208-9016 | 2014-05-16 |
| 1952712630 | Mississippi State Department of Health | Public Health or Welfare | 140 W Mill Road, Bude, MS 39630-7036 | 2014-05-15 |
| 1285045955 | Mississippi State Department of Health | Public Health or Welfare | 7547 Highway 11, Carriere, MS 39426-8904 | 2014-05-15 |
| 1972914653 | Mississippi State Department of Health | Public Health or Welfare | 1000 Irene Street, Liberty, MS 39645-5193 | 2014-05-15 |
| 1609287374 | Mississippi State Department of Health | Public Health or Welfare | 1510 Central Ave E, Wiggins, MS 39577-9633 | 2014-05-15 |
| 1275944993 | Mississippi State Department of Health | Public Health or Welfare | 1185a N Frontage Rd, Prentiss, MS 39474-9302 | 2014-05-15 |
| 1366853087 | Mississippi State Department of Health | Public Health or Welfare | 600 S Arrington Ave, Collins, MS 39428-4159 | 2014-05-15 |
| 1396156063 | Mississippi State Department of Health | Public Health or Welfare | 6912 Washington Ave, Ocean Springs, MS 39564-2133 | 2014-05-15 |
| 1043621881 | Mississippi State Department of Health | Public Health or Welfare | 856 Highway 90, Suite A, Bay St Louis, MS 39520-2736 | 2014-05-14 |
| 1437560216 | Mississippi State Department of Health | Public Health or Welfare | 353a Highway 37, Raleigh, MS 39153-6069 | 2014-05-14 |
| Street Address |
3276 LYNCH ST |
| City | JACKSON |
| State | MS |
| Zip Code | 39209-7205 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235754995 | Oak Street Health Physicians Group of Mississippi, LLC | Family Medicine | 911 Ellis Ave, Jackson, MS 39209 | 2020-06-09 |
| 1760003594 | Phi Health, LLC | Ambulance | 582 Ramp Road, Suite C, Jackson, MS 39209 | 2020-05-04 |
| 1720468911 | Genoa Healthcare, LLC | Pharmacy | 3450 Highway 80 W Rm 68, Jackson, MS 39209 | 2015-06-03 |
| 1013302082 | Tiffany Griffin | Nurse Practitioner | 3450 Highway 80 West, Jackson, MS 39209 | 2015-04-06 |
| 1679961957 | Cassetta Shontae Mcgee | Emergency Medical Technician, Basic | 5326 Queen Eleanor Ln, Jackson, MS 39209 | 2015-01-08 |
| 1124381280 | Martin Solution | In Home Supportive Care | 917 West Ridge, Jackson, MS 39209 | 2012-06-22 |
| 1649533589 | Adrinnie M Martin | Contractor | 917 Westridge, Jackson, MS 39209 | 2012-06-15 |
| 1831423862 | Infinity House, Inc | In Home Supportive Care | 1042 Pecan Park Circle, Jackson, MS 39209 | 2009-09-23 |
| 1174751093 | Linda M Vance | Nurse Practitioner | 1000 Metrocenter Ste 105, Jackson, MS 39209 | 2009-06-30 |
| 1770729998 | Kim Hestle | Speech-Language Pathologist | 733 N. Flag Chapel Road, Jackson, MS 39209 | 2008-12-17 |
| Find all providers in zip 39209 | ||||
| Taxonomy Code | 251K00000X |
| Grouping | Agencies |
| Classification | Public Health or Welfare |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861024747 | Second Chance Outreach Learning Center | Public Health or Welfare | 4807 N State St Ste 407, Jackson, MS 39206-4826 | 2020-02-07 |
| 1285155150 | Helping Hands of Middle & West Tennessee | Public Health or Welfare | 1408 N Highland Ave Ste 100, Jackson, TN 38301-3450 | 2017-06-30 |
| 1184152233 | Tier-3 Solutions, Inc. | Public Health or Welfare | 5255 Keele St Ste C, Jackson, MS 39206-4381 | 2017-06-01 |
| 1992047278 | Burning Bush Youth & Family Intervention Center, Inc. | Public Health or Welfare | 144 Brookwood Ave, Jackson, GA 30233-1403 | 2013-03-25 |
| 1114222379 | State of Tennessee | Public Health or Welfare | 295 Summar Drive, Jackson, TN 38301 | 2011-01-20 |
| 1881890424 | Northampton County Dss | Public Health or Welfare | 9467 Nc 305 Hwy., Jackson, NC 27845 | 2007-06-21 |
| 1770637969 | Breathitt County Health Department | Public Health or Welfare | 955 Hwy. 30 West, Jackson, KY 41339-1000 | 2007-01-23 |
| 1265582415 | West Tennessee Regional Health Office Children Special Services | Public Health or Welfare | 295 Summar Ave, Jackson, TN 38301 | 2007-01-11 |
| 1376606582 | Mississipp State Department of Health | Public Health or Welfare | 3156 Lawson Street, Jackson, MS 39213 | 2006-12-18 |
| 1871676593 | Jackson Madison County Regional Health Department | Public Health or Welfare | 804 North Parkway, Jackson, TN 38305-3058 | 2006-10-24 |
| Find all providers in JACKSON | ||||
Please comment or provide details below to improve the information on MISSISSIPPI STATE DEPARTMENT OF HEALTH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.