Healthcare Provider Details

I. General information

NPI: 1205811304
Provider Name (Legal Business Name): NORTH OAK REGIONAL HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2005
Last Update Date: 09/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 GETWELL DR
SENATOBIA MS
38668-2213
US

IV. Provider business mailing address

401 GETWELL DR
SENATOBIA MS
38668-2213
US

V. Phone/Fax

Practice location:
  • Phone: 662-562-3100
  • Fax: 662-560-6295
Mailing address:
  • Phone: 662-562-3100
  • Fax: 662-560-6295

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number16-286
License Number StateMS

VIII. Authorized Official

Name: MRS. SONJA GRAHAM
Title or Position: CHEIF EXECUTIVE OFFICER
Credential: RN
Phone: 662-562-3100