Organization
SOUTHERN HEALTH CORP OF HOUSTON, INC.
Active
Other names
Trace Regional Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHEILA BROCKMAN (CEO)
(662) 456-3700
Entity
Organization
Contact information
Practice address
1002 E MADISON ST, HOUSTON, MS 38851-2428
(662) 456-3700
(662) 456-1083
Mailing address
PO BOX 626, HOUSTON, MS 38851
(662) 456-3701
(662) 456-1083
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
12296
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000020031
BC
—
05
—
00220415
—
MS
05
—
00220424
—
MS
05
—
09013117
—
MS
05
—
09013354
—
MS
01
—
C 02044
MEDICARE / CAHABA
MS
01
—
C00717
MEDICARE / CAHABA
MS
01
—
C02335
MEDICARE / CAHABA
MS
Enumeration date
07/26/2006
Last updated
01/18/2024
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