Healthcare Provider Details

I. General information

NPI: 1679553994
Provider Name (Legal Business Name): MAGEE BENEVOLENT ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 3RD AVE SE
MAGEE MS
39111-3665
US

IV. Provider business mailing address

300 3RD AVE SE
MAGEE MS
39111-3665
US

V. Phone/Fax

Practice location:
  • Phone: 601-849-5070
  • Fax: 601-849-7116
Mailing address:
  • Phone: 601-849-5070
  • Fax: 601-849-7116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number13-274
License Number StateMS

VIII. Authorized Official

Name: MRS. ALTHEA H CRUMPTON
Title or Position: C E O
Credential:
Phone: 601-849-5070