Healthcare Provider Details

I. General information

NPI: 1629235023
Provider Name (Legal Business Name): COVINGTON COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2008
Last Update Date: 09/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 S HOLLY AVE
COLLINS MS
39428-3894
US

IV. Provider business mailing address

P.O. BOX 2499
COLLINS MS
39428-2499
US

V. Phone/Fax

Practice location:
  • Phone: 601-765-3180
  • Fax: 601-765-2808
Mailing address:
  • Phone: 601-765-3180
  • Fax: 601-765-2808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. CHAS PIERCE
Title or Position: PFS DIRECTOR
Credential:
Phone: 601-423-0004