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General NPI Number Information
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NPI Number | 1740795806
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Entity Type | Organization
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Legal Business Name | FORREST GENERAL HOSPITAL
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Dates
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Enumeration Date | 12/11/2017
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Last Update Date | 12/11/2017
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Provider Practice Location Address
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Address Line | 1414 SOUTH 28TH AVENUE
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City | HATTIESBURG
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State | MS
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Zip | 39401
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Country | US
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Telephone | 601-288-2438
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Fax | 601-288-2486
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Provider Business Mailing Address
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Address Line | 1414 SOUTH 28TH AVENUE
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City | HATTIESBURG
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State | MS
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Zip | 39401
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Country | US
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Telephone | 601-288-2438
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Fax | 601-288-2486
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | BEN HESTER
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Credential |
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Telephone | 601-288-4225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number | 04235.5.1
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 042355.1
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License Number State | MS
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