Healthcare Provider Details

I. General information

NPI: 1942547161
Provider Name (Legal Business Name): YALOBUSHA GENERAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2013
Last Update Date: 01/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14101 HICKORY ST.
OAKLAND MS
38948
US

IV. Provider business mailing address

14101 HICKORY STREET
OAKLAND MS
38948
US

V. Phone/Fax

Practice location:
  • Phone: 662-473-1411
  • Fax:
Mailing address:
  • Phone:
  • 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: JOE MEURRIER
Title or Position: CLINIC ADMINISTRATOR
Credential:
Phone: 662-473-1411