Healthcare Provider Details

I. General information

NPI: 1275700064
Provider Name (Legal Business Name): FORREST COUNTY GENERAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2008
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 HIGHLAND PKWY
PICAYUNE MS
39466-5574
US

IV. Provider business mailing address

130 HIGHLAND PKWY
PICAYUNE MS
39466-5574
US

V. Phone/Fax

Practice location:
  • Phone: 601-358-9420
  • Fax: 601-358-9421
Mailing address:
  • Phone: 601-358-9420
  • Fax: 601-358-9421

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number11086
License Number StateMS

VIII. Authorized Official

Name: BEN HESTER
Title or Position: CFO
Credential:
Phone: 601-288-4225