MEDICARE: SINGING RIVER HEALTH SYSTEM

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
1	261QR1300X	Rural Health Clinic/Center

General Provider Information

NPI Number	:	1255728838
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SINGING RIVER HEALTH SYSTEM

Provider Business Mailing Address
First Line	:	2101 HIGHWAY 90
Second Line	:
City	:	GAUTIER
State	:	MS
Zip	:	39553-5340
Country	:	US
Telephone Number	:	228-497-8874
Fax Number	:

Provider Business Practice Location Address
First Line	:	11700 HIGHWAY 57
Second Line	:
City	:	VANCLEAVE
State	:	MS
Zip	:	39565-8309
Country	:	US
Telephone Number	:	228-826-1482
Fax Number	:

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	LEE BOND
Credential	:
Telephone Number	:	228-497-7591

Provider Enumeration Date	:	04/21/2015
Last Update Date	:	04/21/2015

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Directions to “SINGING RIVER HEALTH SYSTEM ” Practice Location

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