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General NPI Number Information
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NPI Number | 1043051543
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Entity Type | Organization
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Legal Business Name | COVINGTON COUNTY HOSPITAL
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Dates
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Enumeration Date | 06/06/2024
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 347 MAGNOLIA DR
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City | RALEIGH
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State | MS
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Zip | 39153-6011
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Country | US
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Telephone | 601-698-0328
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Fax | 601-698-0112
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Provider Business Mailing Address
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Address Line | PO BOX 2499
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City | COLLINS
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State | MS
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Zip | 39428-2499
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Country | US
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Telephone | 601-765-6711
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Fax | 601-698-0112
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Authorized Official
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Title or Position | CREDENTIALING DIRECTOR
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Name | ANISSA L PROMISE
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Credential |
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Telephone | 601-698-0328
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NR1301X
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Taxonomy Name | Rural Acute Care Hospital
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License Number |
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License Number State |
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