Provider Demographics
NPI:1659254639
Name:TISHOMINGO HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:TISHOMINGO HEALTH SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CORPORATE SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:TOPPIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-377-4229
Mailing Address - Street 1:808 VARSITY DR
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-4613
Mailing Address - Country:US
Mailing Address - Phone:662-377-3868
Mailing Address - Fax:
Practice Address - Street 1:1777 CURTIS DRIVE
Practice Address - Street 2:
Practice Address - City:IUKA
Practice Address - State:MS
Practice Address - Zip Code:38852
Practice Address - Country:US
Practice Address - Phone:662-443-0968
Practice Address - Fax:662-443-0969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-28
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center