Healthcare Provider Details

I. General information

NPI: 1235439571
Provider Name (Legal Business Name): MAGEE BENEVOLENT ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2010
Last Update Date: 11/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 HIGHWAY 28
MIZE MS
39116-5867
US

IV. Provider business mailing address

300 3RD AVENUE SE MAGEE GENERAL HOSPITAL
MAGEE MS
39111
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

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