Provider Demographics
NPI:1730342643
Name:FIELD MEMORIAL COMMUNITY HOSPITAL
Entity type:Organization
Organization Name:FIELD MEMORIAL COMMUNITY HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHOUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-645-5221
Mailing Address - Street 1:PO BOX 639
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39631-0639
Mailing Address - Country:US
Mailing Address - Phone:601-645-5221
Mailing Address - Fax:601-645-5873
Practice Address - Street 1:270 W MAIN STREET
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:MS
Practice Address - Zip Code:39631
Practice Address - Country:US
Practice Address - Phone:601-645-5221
Practice Address - Fax:601-645-5873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-10
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty