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General NPI Number Information
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NPI Number | 1295810901
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Entity Type | Organization
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Legal Business Name | HOLMES COUNTY LONG TERM CARE CENTER - DURANT
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 01/09/2008
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Provider Practice Location Address
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Address Line | 15481 BOWLING GREEN RD
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City | DURANT
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State | MS
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Zip | 39063-3565
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Country | US
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Telephone | 662-834-1321
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Fax |
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Provider Business Mailing Address
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Address Line | 15481 BOWLING GREEN RD
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City | DURANT
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State | MS
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Zip | 39063-3565
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Country | US
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Telephone | 662-834-1321
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF PATIENT FINANCIAL SERVI
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Name | MR. WILLIAM L KENNEDY
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Credential |
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Telephone | 601-984-4680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 652
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License Number State | MS
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