Healthcare Provider Details

I. General information

NPI: 1134326259
Provider Name (Legal Business Name): HANCOCK MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2007
Last Update Date: 03/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16230 HIGHWAY 603
KILN MS
39566-6230
US

IV. Provider business mailing address

149 DRINKWATER BLVD.
BAY SAINT LOUIS MS
39520-1658
US

V. Phone/Fax

Practice location:
  • Phone: 228-255-5200
  • Fax: 228-255-5250
Mailing address:
  • Phone: 228-467-8787
  • Fax: 228-467-8799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number11214
License Number StateMS

VIII. Authorized Official

Name: MR. THOMAS P RAMSEY
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 228-467-8787