Healthcare Provider Details

I. General information

NPI: 1962395863
Provider Name (Legal Business Name): SOUTH SUNFLOWER COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2025
Last Update Date: 05/30/2025
Certification Date: 05/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 E BAKER ST
INDIANOLA MS
38751-2498
US

IV. Provider business mailing address

121 E BAKER ST
INDIANOLA MS
38751-2498
US

V. Phone/Fax

Practice location:
  • Phone: 662-635-7210
  • Fax:
Mailing address:
  • Phone: 662-635-7210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State

VIII. Authorized Official

Name: COURTNEY PHILLIPS
Title or Position: CEO
Credential:
Phone: 662-635-7200