Organization
INDEPENDENT HEALTHCARE MANAGEMENT, INC
Active
Other names
S.E. Lackey Memorial Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH S MCNULTY III CRT (PRESIDENT)
(601) 849-4112
Entity
Organization
Contact information
Practice address
330 N BROAD ST, FOREST, MS 39074-3508
(601) 469-4151
(601) 469-3681
Mailing address
PO BOX 1100, MAGEE, MS 39111-1100
(601) 849-6440
(601) 849-7557
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
13033
MS
Other
Enumeration date
07/13/2006
Last updated
12/19/2008
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