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General NPI Number Information
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NPI Number | 1326112822
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Entity Type | Organization
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Legal Business Name | SOUTH MISSISSIPPI HEALTH CARE
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Dates
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Enumeration Date | 11/17/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2401 HARDY ST SUITE 20
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City | HATTIESBURG
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State | MS
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Zip | 39401-5912
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Country | US
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Telephone | 601-544-5922
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Fax | 601-544-5923
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Provider Business Mailing Address
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Address Line | 2401 HARDY ST SUITE 20
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City | HATTIESBURG
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State | MS
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Zip | 39401-5912
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Country | US
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Telephone | 601-544-5922
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Fax | 601-544-5923
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JAMES DAVID COOK
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Credential | M.B.A.
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Telephone | 601-544-5922
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State | MS
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