Healthcare Provider Details

I. General information

NPI: 1053350462
Provider Name (Legal Business Name): FORREST COUNTY GENERAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 09/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 HIGHLAND PARKWAY
PICAYUNE MS
39466-3221
US

IV. Provider business mailing address

130 HIGHLAND PARKWAY
PICAYUNE MS
39466-3221
US

V. Phone/Fax

Practice location:
  • Phone: 601-798-4711
  • Fax: 601-749-3187
Mailing address:
  • Phone: 601-798-4711
  • Fax: 601-749-3187

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number11086
License Number StateMS

VIII. Authorized Official

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