MEDICARE: FOREST HILL NURSING CENTER, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility		MS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073546230
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOREST HILL NURSING CENTER, INC.

Provider Business Mailing Address
First Line	:	927 COOPER RD
Second Line	:
City	:	JACKSON
State	:	MS
Zip	:	39212-4023
Country	:	US
Telephone Number	:	601-372-0141
Fax Number	:	601-372-0931

Provider Business Practice Location Address
First Line	:	927 COOPER RD
Second Line	:
City	:	JACKSON
State	:	MS
Zip	:	39212-4023
Country	:	US
Telephone Number	:	601-372-0141
Fax Number	:	601-372-0931

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. MIMS RAY JONES
Credential	:
Telephone Number	:	601-372-0141

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	08/22/2020

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