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Organization
INDEPENDENT HEALTHCARE MANAGEMENT, INC.
Active
Organization
INDEPENDENT HEALTHCARE MANAGEMENT, INC.
Active
Other names
SE Lackey Memorial Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN LEE MD (CHAIRMAN OF BOARD)
(601) 469-4861
Entity
Organization
Contact information
Practice address
516 AIRPORT RD, FOREST, MS 39074-4032
(601) 469-4151
(601) 469-3681
Mailing address
PO BOX 1460, MAGEE, MS 39111-1460
(601) 849-6440
(601) 849-1332
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13-033
HOSPITAL LICENSE
MS
Enumeration date
08/10/2021
Last updated
08/10/2021
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