Organization
CLAIBORNE COUNTY NURSING CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TINA L ELLIS (COMPTROLLER)
(601) 304-0980
Entity
Organization
Contact information
Practice address
2124 OLD HIGHWAY 61 S, PORT GIBSON, MS 39150-2589
(601) 437-8737
(601) 437-8724
Mailing address
PO BOX 1018, 2124 OLD HWY 61 SOUTH, PORT GIBSON, MS 39150-1018
(601) 437-8737
(601) 437-8724
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
679
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00023182
—
MS
Enumeration date
12/06/2005
Last updated
08/22/2020
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