St. Dominic-Jackson Memorial Hospital

LBN: St. Dominic-Jackson Memorial Hospital
St. Dominic-Jackson Memorial Hospital is an health care organization with primary practice located at 969 Lakeland Dr , Jackson MS 39216-4606. The organization recently has only one registered license in Suppliers / Institutional Pharmacy, which is considered as the primary health care specialty. St. Dominic-Jackson Memorial Hospital can be contacted via phone (601) 200-6000, or through Scott, Samuel Thaddeus via phone (601) 200-6570.

Contact Information

Primary practice address
969 Lakeland Dr Jackson MS 39216-4606
Phone: (601) 200-6000
Fax: (601) 321-5170
Website:
Map and Directions
Authorized official contact:
Name: Scott, Samuel Thaddeus
Phone: (601) 200-6570

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Institutional Pharmacy 3336I0012X 0101003.1 Mississippi

Profile Details

NPI number 1003979386
LBN Legal business name St. Dominic-Jackson Memorial Hospital
DBA Doing business as
Authorized official Scott, Samuel Thaddeus
Entity Organization
Organization subpart 1 No
Enumeration date Dec 18th, 2006
Last updated May 13th, 2024 - about 7 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003979386 NPPES
Mississippi Other 20034 BLUE CROSS
Mississippi MEDICAID 000020034 BLUE CROSS

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