Organization
COVENANT HEALTH & REHAB OF VICKSBURG, LP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JUDY ULLERY (PRESIDENT)
(901) 937-7994
Entity
Organization
Contact information
Practice address
2850 PORTERS CHAPEL RD, VICKSBURG, MS 39180-1805
(601) 638-9211
(601) 636-4986
Mailing address
2850 PORTERS CHAPEL RD, VICKSBURG, MS 39180-1805
(601) 638-9211
(601) 636-4986
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
595
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0220282
—
MS
Enumeration date
05/11/2006
Last updated
08/10/2007
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