Organization
INDEPENDENT HEALTHCARE MANAGEMENT, INC.
Active
Other names
SE Lackey Memorial Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN LEE MD (CHAIRMAN OF BOARD)
(601) 469-4861
Entity
Organization
Contact information
Practice address
516 AIRPORT RD, FOREST, MS 39074-4032
(601) 469-4151
(601) 469-3681
Mailing address
PO BOX 1460, MAGEE, MS 39111-1460
(601) 849-6440
(601) 849-1332
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13-033
HOSPITAL LICENSE
MS
Enumeration date
08/10/2021
Last updated
08/10/2021
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