Healthcare Provider Details

I. General information

NPI: 1902844194
Provider Name (Legal Business Name): NOXUBEE GENERAL CRITICAL ACCESS HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 10/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 NORTH JEFFERSON STREET
MACON MS
39341
US

IV. Provider business mailing address

PO BOX 480
MACON MS
39341-0480
US

V. Phone/Fax

Practice location:
  • Phone: 662-726-4231
  • Fax: 662-726-5784
Mailing address:
  • Phone: 662-726-4231
  • Fax: 662-726-5784

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number11-081
License Number StateMS

VIII. Authorized Official

Name: DANNY H MCKAY
Title or Position: ADMINISTRATOR
Credential:
Phone: 662-726-4231