Organization
INDEPENDENT HEALTHCARE MANAGEMENT, INC.
Active
Other names
S.E. Lackey Memorial Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN P LEE (CHAIRMAN OF THE BOARD)
(601) 849-6440
Entity
Organization
Contact information
Practice address
330 N BROAD ST, FOREST, MS 39074-3508
(601) 469-4151
(601) 469-3681
Mailing address
330 N BROAD ST, FOREST, MS 39074-3508
(601) 469-4151
(601) 469-3681
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
13-033
MS
367500000X
Certified Registered Nurse Anesthetist
13-033
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09013844
—
MS
Enumeration date
02/17/2010
Last updated
05/26/2020
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