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General NPI Number Information
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NPI Number | 1639772288
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Entity Type | Organization
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Legal Business Name | SOUTHWEST MISSISSIPPI REGIONAL MEDICAL CENTER
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Dates
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Enumeration Date | 11/17/2020
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Last Update Date | 11/17/2020
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Provider Practice Location Address
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Address Line | 215 MARION AVE
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City | MCCOMB
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State | MS
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Zip | 39648-2705
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Country | US
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Telephone | 601-249-1497
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Fax | 601-249-1397
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Provider Business Mailing Address
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Address Line | PO BOX 1307
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City | MCCOMB
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State | MS
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Zip | 39649-1307
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Country | US
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Telephone | 601-249-1497
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Fax | 601-249-1397
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Authorized Official
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Title or Position | CEO
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Name | CHARLA ROWLEY
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Credential |
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Telephone | 601-249-1806
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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