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General NPI Number Information
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NPI Number | 1801140082
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Entity Type | Organization
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Legal Business Name | YALOBUSHA GENERAL HOSPITAL
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Dates
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Enumeration Date | 11/09/2012
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Last Update Date | 11/09/2012
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Provider Practice Location Address
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Address Line | 630 S MAIN ST
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City | WATER VALLEY
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State | MS
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Zip | 38965-3468
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Country | US
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Telephone | 662-473-1411
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Fax | 662-473-4922
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Provider Business Mailing Address
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Address Line | 630 S MAIN ST
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City | WATER VALLEY
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State | MS
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Zip | 38965-3468
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Country | US
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Telephone | 662-473-1411
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Fax | 662-473-4922
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. TERRY VARNER
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Credential |
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Telephone | 662-473-1411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 158, YALOBUSHA
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License Number State | MS
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