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General NPI Number Information
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NPI Number | 1659555761
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Entity Type | Organization
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Legal Business Name | TALLAHATCHIE GENERAL HOSPITAL AND EXTENDED CARE FACILITY
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Dates
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Enumeration Date | 12/26/2007
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Last Update Date | 05/12/2025
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Provider Practice Location Address
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Address Line | 141 DR T. T. LEWIS CIRCLE
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City | CHARLESTON
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State | MS
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Zip | 38921
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Country | US
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Telephone | 662-647-5535
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Fax | 662-647-8432
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Provider Business Mailing Address
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Address Line | PO BOX 230
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City | CHARLESTON
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State | MS
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Zip | 38921
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Country | US
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Telephone | 662-647-5535
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Fax | 662-647-8432
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Authorized Official
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Title or Position | REVENUE CYCLE DIRECTOR
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Name | HEATHER HOLEMAN GODSEY
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Credential |
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Telephone | 662-625-7191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 1054
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License Number State | MS
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