Organization
UNIV HOSPITAL HOLMES COUNTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEWERY MONTGOMERY (INTERIM ADMINISTRATOR)
(662) 834-1321
Entity
Organization
Contact information
Practice address
239 BOWLING GREEN RD, LEXINGTON, MS 39095-5167
(662) 834-1321
(662) 834-5141
Mailing address
239 BOWLING GREEN RD, LEXINGTON, MS 39095-5167
(662) 834-1321
(662) 834-5141
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
11-199-S-2
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19838
BLUE CROSS
MS
01
—
258513
MEDICARE
—
05
—
6300013
—
MS
Enumeration date
11/29/2007
Last updated
11/29/2007
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