Organization
SHARKEY ISSAQUENA COMMUNITY HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN GERALD KEEVER (ADMINISTRATOR)
(662) 873-4395
Entity
Organization
Contact information
Practice address
47 S FOURTH ST, ROLLING FORK, MS 39159-5146
(662) 873-4395
(662) 873-5188
Mailing address
PO BOX 339, ROLLING FORK, MS 39159-0339
(662) 873-4395
(662) 873-5188
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
21-172
MS
282NC0060X
Critical Access Hospital
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0020129
—
MS
05
—
0029129
—
MS
05
—
0050033
—
MS
01
—
20129
BLUE CROSS BLUE SHIELD
MS
05
—
9013018
—
MS
05
—
9013019
—
MS
Enumeration date
10/06/2006
Last updated
07/07/2023
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