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Organization
KILMICHAEL HOSPITAL
Active
Organization
KILMICHAEL HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CALVIN JOHNSON (ADMINISTRATOR)
(662) 262-4311
Entity
Organization
Contact information
Practice address
301 LAMAR AVENUE, KILMICHAEL, MS 39747-0188
(662) 262-4311
(662) 262-5586
Mailing address
PO BOX 188, 301 LAMAR AVENUE, KILMICHAEL, MS 39747-0188
(662) 262-4311
(662) 262-5586
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
21183
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00020147
BLUE CROSS BLUE SHIELD MS
MS
05
—
00020147
—
MS
05
—
03335377
—
MS
Enumeration date
11/30/2005
Last updated
08/24/2007
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