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NPI Code Detail

MEDICARE: FORREST COUNTY GENERAL HOSPITAL

MEDICARE: FORREST COUNTY GENERAL HOSPITAL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251G00000XCommunity Based Hospice Care Agency008MS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1013002724
Entity Type Code : Organization
Provider Name (Legal Business Name) : FORREST COUNTY GENERAL HOSPITAL
Provider Business Mailing Address
First Line : 1414 S 28TH AVE
Second Line :
City : HATTIESBURG
State : MS
Zip : 39402-3107
Country : US
Telephone Number : 601-288-4344
Fax Number : 601-288-2401
Provider Business Practice Location Address
First Line : 1414 S 28TH AVE
Second Line :
City : HATTIESBURG
State : MS
Zip : 39402-3107
Country : US
Telephone Number : 601-288-4344
Fax Number : 601-288-2401
Authorized Official
Title or Position : BUSINESS MANAGER
Name : MR. JAMES LARRY RUSSUM
Credential :
Telephone Number : 601-288-4344
Provider Enumeration Date : 10/04/2006
Last Update Date : 05/30/2014

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Directions to “FORREST COUNTY GENERAL HOSPITAL ” Practice Location

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