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NPI Code Detail

MEDICARE: CLAIBORNE COUNTY HOSPITAL

MEDICARE: CLAIBORNE COUNTY HOSPITAL
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
1282NC0060XCritical Access Hospital

General Provider Information

NPI Number : 1700836350
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLAIBORNE COUNTY HOSPITAL
Provider Business Mailing Address
First Line : P O BOX 1004
Second Line : 123 MCCOMB AVE
City : PORT GIBSON
State : MS
Zip : 39150-2915
Country : US
Telephone Number : 601-437-5141
Fax Number : 601-437-3782
Provider Business Practice Location Address
First Line : 123 MCCOMB AVE
Second Line :
City : PORT GIBSON
State : MS
Zip : 39150-2915
Country : US
Telephone Number : 601-437-5141
Fax Number : 601-437-3782
Authorized Official
Title or Position : CEO
Name : RAY L SHOEMAKER
Credential :
Telephone Number : 662-321-1155
Provider Enumeration Date : 05/12/2006
Last Update Date : 06/14/2010

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Directions to “CLAIBORNE COUNTY HOSPITAL ” Practice Location

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