Organization
KILMICHAEL HOSPITAL
Active
Other names
Kilmichael Hospital Swingbed
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CALVIN DEXTER JOHNSON (ADMINISTRATOR)
(662) 262-4311
Entity
Organization
Contact information
Practice address
301 LAMAR AVE, KILMICHAEL, MS 39747
(662) 262-4311
(662) 262-5586
Mailing address
PO BOX 188, KILMICHAEL, MS 39747-0188
(662) 262-4311
Taxonomy
Speciality
Code
Description
License number
State
275N00000X
Medicare Defined Swing Bed Hospital Unit
Primary
21-183
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00029147
—
MS
Enumeration date
05/22/2007
Last updated
08/22/2020
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