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Contact Information

ELLISVILLE STATE SCHOOL
1101 HIGHWAY 11 S
ELLISVILLE, MS39437-4443
 Phone: 601-477-9384
 Fax: 601-477-5700
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Health Maintenance Organization

302R00000X
Indicates primary specialty

NPI Profile & details for ELLISVILLE STATE SCHOOL

NPI # 1720181191
LBN Legal business name ELLISVILLE STATE SCHOOL
Authorized official PAM YOUNG - (ACCOUNTING AUDITOR 1)
Entity Organization
Organization subpart 1 No
Enumeration date 09/07/2006
Last updated 06/12/2008 - About 18 years ago
Identifiers
MS License # 233
MS Medicaid 00021831
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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