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General NPI Number Information
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NPI Number | 1336256700
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Entity Type | Organization
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Legal Business Name | FORREST COUNTY GENERAL HOSPITAL
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 4200 MAMIE ST STE 120
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City | HATTIESBURG
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State | MS
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Zip | 39402-1749
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Country | US
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Telephone | 601-288-4344
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Fax | 601-288-2401
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Provider Business Mailing Address
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Address Line | 1414 SOUTH 28TH AVE
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City | HATTIESBURG
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State | MS
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Zip | 39402
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Country | US
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Telephone | 601-288-4344
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Fax | 601-288-2401
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Authorized Official
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Title or Position | DIRECTOR
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Name | LESLIE MASTERS
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Credential |
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Telephone | 601-288-4344
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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 | 008
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 4585
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License Number State | MS
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