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General NPI Number Information
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NPI Number | 1013995380
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Entity Type | Organization
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Legal Business Name | SOUTH CENTRAL REGIONAL MEDICAL CENTER
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Dates
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Enumeration Date | 01/05/2006
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Last Update Date | 06/04/2014
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Provider Practice Location Address
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Address Line | 2260 US HIGHWAY 15 NORTH
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City | LAUREL
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State | MS
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Zip | 39440-1521
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Country | US
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Telephone | 601-422-0054
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Fax | 601-399-6275
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Provider Business Mailing Address
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Address Line | PO BOX 607
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City | LAUREL
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State | MS
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Zip | 39441-0607
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Country | US
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Telephone | 601-422-0054
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Fax | 601-399-6275
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Authorized Official
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Title or Position | VICEPRESIDENT/ CFO
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Name | MR. JAMES T CANIZARO
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Credential |
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Telephone | 601-399-6139
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 013
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License Number State | MS
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