Organization
MADISON COUNTY GENERAL HOSPITAL
Active
Other names
Madison County Nursing Home
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL LOGAN (MANAGAER)
(601) 855-5771
Entity
Organization
Contact information
Practice address
1421 E PEACE ST, CANTON, MS 39046-4938
(601) 855-5771
(601) 855-5781
Mailing address
1421 E PEACE ST, CANTON, MS 39046-4938
(601) 855-5771
(601) 855-5781
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9016161
—
MS
Enumeration date
05/15/2007
Last updated
08/22/2020
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