Organization
NESHOBA COUNTY GENERAL HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT MCNAIR (CFO)
(601) 663-1233
Entity
Organization
Contact information
Practice address
1001 HOLLAND AVE, PHILADELPHIA, MS 39350-2161
(601) 663-1200
(601) 663-1379
Mailing address
PO BOX 648, PHILADELPHIA, MS 39350-0648
(601) 663-1200
(601) 663-1379
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
11227
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000019181A
BLUE CROSS BLUE SHIELD CRNA
MS
05
—
09013715
—
MS
Enumeration date
03/07/2007
Last updated
07/26/2017
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