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General NPI Number Information
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NPI Number | 1831250075
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Entity Type | Organization
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Legal Business Name | GREENE COUNTY HOSPITAL
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1017 JACKSON AVE
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City | LEAKESVILLE
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State | MS
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Zip | 39451-9105
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Country | US
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Telephone | 601-394-4135
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Fax |
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Provider Business Mailing Address
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Address Line | 200 FOXGATE AVE APT 18B
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City | HATTIESBURG
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State | MS
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Zip | 39402-1876
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Country | US
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Telephone | 601-325-6160
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Fax |
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Authorized Official
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Title or Position | ER PHYSICIAN
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Name | MRS. CIRILA L REYES
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Credential | M.D.
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Telephone | 601-394-4135
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 09382
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License Number State | MS
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