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CHURCH STREET CLINIC
NPI 1720253735
Clinic/Center - Rural Health in Belzoni, MS

Active since April 30, 2008
500 CCC ROAD, BELZONI, MS 39038(662) 247-3831(662) 247-4114 Get Directions Write a Review

NPPES record last updated: June 9, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Church Street Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHURCH STREET CLINIC (NPI 1720253735) is a healthcare organization registered as a rural health in Belzoni, Mississippi and active in the NPI registry since April 2008. The organization lists Ray Shoemaker, Ceo, as its authorized official.

NPPES Registry Identity

NPI1720253735
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameHUMPHREYS COUNTY MEMORIAL HOSPITAL
Location Address500 CCC ROADBelzoni, MS 39038-0000
Mailing AddressPo Box 510Belzoni, MS 39038-0510 · (662) 247-3831 · Fax (662) 247-4114
Phone(662) 247-3831
Fax(662) 247-4114
Organization SubpartNo
Authorized OfficialRay ShoemakerCeo · (662) 321-1155
Enumeration DateApril 30, 2008
Last NPPES UpdateJune 9, 2008
✔ NPI 1720253735 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
500 CCC ROAD, Belzoni, MS 39038
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Other Names 1

Doing Business AsChurch Street Clinic

Other Identifiers 1

Medicare PIN253485

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DAISY MARIE THOMAS M.D.
Family Medicine
500 CCC ROAD
BELZONI, MS 39038
Humphreys County (662) 247-3831
HUMPHREYS COMMUNITY CARE CENTER LLC
Skilled Nursing Facility
500 CCC ROAD
BELZONI, MS 39038
Humphreys County (662) 247-1821

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Humphreys County Memorial Hospital's NPI number?

The NPI number for Humphreys County Memorial Hospital is 1720253735. It was assigned to this organization in the NPPES registry on April 30, 2008. The provider is doing business as Church Street Clinic.

Where is Humphreys County Memorial Hospital located?

Humphreys County Memorial Hospital is located at 500 Ccc Road, Belzoni, MS 39038. The listed phone number is (662) 247-3831.

What is Humphreys County Memorial Hospital's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

When was this NPI record last updated?

The NPPES record for Humphreys County Memorial Hospital was last updated on June 9, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.