Organization
VICKSBURG HEALTHCARE LLC
Active
Other names
Merit Health River Region
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA M LALOR (DIRECTOR/DELEGATED OFFICIAL)
(629) 215-3953
Entity
Organization
Contact information
Practice address
2100 HIGHWAY 61 N, VICKSBURG, MS 39183-8211
(601) 883-5000
(601) 883-5876
Mailing address
PO BOX 841672, DALLAS, TX 75284-1672
(601) 883-5000
(601) 883-5876
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
12-327
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00220571
—
MS
Enumeration date
05/21/2006
Last updated
04/22/2021
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