Organization
CLAIBORNE COUNTY HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAY L SHOEMAKER (CEO)
(662) 321-1155
Entity
Organization
Contact information
Practice address
123 MCCOMB AVENUE, PORT GIBSON, MS 39150-1004
(601) 437-5141
(601) 437-8547
Mailing address
123 MCCOMB AVENUE, PORT GIBSON, MS 39150-1004
(601) 437-5141
(601) 437-5166
Taxonomy
Speciality
Code
Description
License number
State
275N00000X
Medicare Defined Swing Bed Hospital Unit
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00029140
—
MS
Enumeration date
11/02/2006
Last updated
06/14/2010
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