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General NPI Number Information
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NPI Number | 1154465912
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Entity Type | Organization
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Legal Business Name | YALOBUSHA GENERAL HOSPITAL
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Dates
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Enumeration Date | 02/16/2007
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Last Update Date | 12/17/2021
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Provider Practice Location Address
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Address Line | 31 FRONT ST
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City | COFFEEVILLE
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State | MS
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Zip | 38922-3352
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Country | US
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Telephone | 662-675-2775
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Fax | 662-675-8477
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Provider Business Mailing Address
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Address Line | 31 FRONT ST
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City | COFFEEVILLE
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State | MS
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Zip | 38922-3352
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Country | US
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Telephone | 662-675-2775
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Fax | 662-675-8477
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | JESSICA EMBRY
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Credential | CEO
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Telephone | 662-675-2775
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 01605011
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License Number State | MS
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