Provider Demographics
NPI:1902538382
Name:MISSISSIPPI BAPTIST MINISTRY INC
Entity Type:Organization
Organization Name:MISSISSIPPI BAPTIST MINISTRY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:
Authorized Official - Last Name:BROOME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-596-3786
Mailing Address - Street 1:6 DAVID PATTERSON RD
Mailing Address - Street 2:
Mailing Address - City:MOSELLE
Mailing Address - State:MS
Mailing Address - Zip Code:39459-9439
Mailing Address - Country:US
Mailing Address - Phone:601-596-3786
Mailing Address - Fax:601-586-8304
Practice Address - Street 1:6 DAVID PATTERSON RD
Practice Address - Street 2:
Practice Address - City:MOSELLE
Practice Address - State:MS
Practice Address - Zip Code:39459-9439
Practice Address - Country:US
Practice Address - Phone:601-596-3786
Practice Address - Fax:601-586-8304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-25
Last Update Date:2022-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RM2200XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyMedical LaboratoryGroup - Single Specialty