Healthcare Provider Details

I. General information

NPI: 1740329341
Provider Name (Legal Business Name): FORREST COUNTY GENERAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 03/01/2021
Certification Date: 02/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 WEST MOODY STREET
POPLARVILLE MS
39470
US

IV. Provider business mailing address

125 S 28TH AVE STE 326
HATTIESBURG MS
39401-7152
US

V. Phone/Fax

Practice location:
  • Phone: 601-795-4543
  • Fax: 601-795-4238
Mailing address:
  • Phone: 601-288-1823
  • Fax: 601-288-4360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number
License Number State

VIII. Authorized Official

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