Healthcare Provider Details

I. General information

NPI: 1063177228
Provider Name (Legal Business Name): QUITMAN COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2021
Last Update Date: 10/25/2022
Certification Date: 10/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 GETWELL DR
MARKS MS
38646-3864
US

IV. Provider business mailing address

340 GETWELL DR
MARKS MS
38646-8608
US

V. Phone/Fax

Practice location:
  • Phone: 662-934-3900
  • Fax:
Mailing address:
  • Phone: 662-934-3900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number State

VIII. Authorized Official

Name: MR. LESTER WILKINSON II
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 662-934-3900