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Organization

SHEARER RICHARDSON MEMORIAL NURSINGHOME

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRENDA G WISE (ADMINISTRATOR)
(662) 447-3311
Entity
Organization

Contact information

Practice address
512 ROCKWELL DR, OKOLONA, MS 38860
(662) 447-3311
(662) 447-3856
Mailing address
512 ROCKWELL DR, OKOLONA, MS 38860
(662) 447-3311
(662) 447-3856

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
153
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00230091
SC
Enumeration date
07/17/2006
Last updated
02/12/2013
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