JACKSON VAMC


Address: 1308 Harrison Ave, Mccomb, MS 39648-2830
Phone: 6153553451

JACKSON VAMC (NPI# 1467762120) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1467762120
Entity Type Organization
Organization Name JACKSON VAMC
Other Organization Name MCCOMB VA CBOC
Practice Address 1308 Harrison Ave
Mccomb
MS 39648-2830
Mailing Address Po Box 94497
Cleveland
OH 44101-4497
Practice Telephone 6153553451
Mailing Telephone 6153553451
Enumeration Date 2010-10-15
Last Update Date 2017-10-04
Authorized Official Name ERIN POTTER (NPI TEAM MEMBER)
Authorized Official Telephone 2023822579
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QV0200X Clinic/Center
Specialization: VA
Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
McComb VA CBOC Other Name - Individual/Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1407303050 Jackson Vamc Clinic/Center 6522 Dogwood View Parkway, Suite F, Jackson, MS 39213-7858 2016-09-01
1841232097 Jackson Vamc Clinic/Center 405 W Adams St, Kosciusko, MS 39090-3617 2006-06-12
1043250418 Jackson Vamc Clinic/Center 1502 S Colorado St, Greenville, MS 38703-7219 2006-06-07
1669410288 Jackson Vamc Clinic/Center 2103 13th St, Meridian, MS 39301-4045 2006-06-04
1528006152 Jackson Vamc Clinic/Center 105 Northgate Rd, Suite 2, Natchez, MS 39120-9162 2006-06-04
1376598698 Jackson Vamc Clinic/Center 5003 Hardy Street, Tower B Suite 402, Hattiesburg, MS 39402-1331 2006-05-24
1295787364 Jackson Vamc Clinic/Center 824 Alabama St, Columbus, MS 39702-5436 2006-05-17
1154784965 Jackson Vamc Psychiatric Residential Treatment Facility 1500 Woodrow Wilson Ave, Jackson, MS 39216-5116 2016-03-30
1922496280 Jackson Vamc Clinic/Center 1500 E Woodrow Wilson Ave, Jackson, MS 39216-5116 2015-01-08
1992754543 Jackson Vamc General Acute Care Hospital 1500 E Woodrow Wilson Ave, Jackson, MS 39216-5116 2006-05-10

Office Location

Street Address 1308 HARRISON AVE
City MCCOMB
State MS
Zip Code 39648-2830

Providers in the same location

NPI Name Taxonomy Address Enumeration
1871505008 Nileshkumar Kantilal Kothari Internal Medicine 1308 Harrison Ave, Mccomb, MS 39648-2830 2006-08-13
1013461433 Rex Anne Leggett Registered Nurse 1308 Harrison Ave, Mccomb, MS 39648-2830 2016-08-15

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1952910366 Ct Stamps Inc Pharmacy 206 Marion Avenue, Mccomb, MS 39648 2020-07-31
1952910457 Fresenius Medical Care East Mccomb Dialysis, LLC Clinic/Center 103 Business Center Drive, Mccomb, MS 39648 2020-07-30
1902423312 Joseph Edward Mingo II Counselor 513 Lee St, Mccomb, MS 39648 2020-07-01
1427608769 Benda Truvillion Technician 2128 Park Dr. Ext., Mccomb, MS 39648 2019-09-18
1295228187 Edna Ruth Winston Counselor Sw Ms Mental Health Complex, 1701 White St, Mccomb, MS 39648 2018-06-14
1386153450 Sholitha Nunnery Counselor 502 North Cherry Street, Mccomb, MS 39648 2017-09-21
1548600612 Jordan Harrington Nurse Practitioner 303 Marion Ave., Mccomb, MS 39648 2013-07-03
1891096236 Zwound Care Family Medicine 1126 Country Club Road, Mccomb, MS 39648 2010-11-16
1588891717 Kelly Edmondson Physical Therapy Assistant 1301a Harrison Ave, Mccomb, MS 39648 2009-06-15
1962647651 Gwendolyn Michelle Brown Home Health Aide 1114 1/2 Venable St., Mccomb, MS 39648 2008-12-09
Find all providers in zip 39648

Taxonomy Information

Taxonomy Code 261QV0200X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization VA

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1407303050 Jackson Vamc Clinic/Center 6522 Dogwood View Parkway, Suite F, Jackson, MS 39213-7858 2016-09-01
1841232097 Jackson Vamc Clinic/Center 405 W Adams St, Kosciusko, MS 39090-3617 2006-06-12
1043250418 Jackson Vamc Clinic/Center 1502 S Colorado St, Greenville, MS 38703-7219 2006-06-07
1669410288 Jackson Vamc Clinic/Center 2103 13th St, Meridian, MS 39301-4045 2006-06-04
1528006152 Jackson Vamc Clinic/Center 105 Northgate Rd, Suite 2, Natchez, MS 39120-9162 2006-06-04
1073552436 Memphis Vamc Clinic/Center 1114 Commonwealth Blvd., Tupelo, MS 38804-9998 2006-06-04
1376598698 Jackson Vamc Clinic/Center 5003 Hardy Street, Tower B Suite 402, Hattiesburg, MS 39402-1331 2006-05-24
1194778357 Memphis Vamc Clinic/Center 1700 Crescent Meadows, Holly Springs, MS 38635-7414 2006-05-18
1295787364 Jackson Vamc Clinic/Center 824 Alabama St, Columbus, MS 39702-5436 2006-05-17
1972044048 Dewona Flowers Clinic/Center 604 Lexington Cv, Byram, MS 39272-3004 2017-03-09
Find all providers with the same taxonomy

Competitor

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City MCCOMB
Zip Code 39648

Improve Information

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Dataset Information

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.

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