Organization
PRENTISS REGIONAL HOSPITAL AND ECF, INC.
Active
Other names
Jefferson Davis Community Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
GARY LEE MCCALL JR. (COO)
(601) 792-4276
Entity
Organization
Contact information
Practice address
1320 WINFIELD ST., PRENTISS, MS 39474
(601) 792-4276
(601) 792-2947
Mailing address
PO BOX 1288, PRENTISS, MS 39474-1288
(601) 792-4276
(601) 792-2947
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
254
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00230059
—
MS
Enumeration date
03/05/2007
Last updated
08/22/2020
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