Organization
PONTOTOC LTC, INC
Active
Other names
Pontotoc Health & Rehab Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GENE BENNETT HUBBARD JR. (OWNER)
(601) 849-2294
Entity
Organization
Contact information
Practice address
278 W 8TH ST, PONTOTOC, MS 38863-3612
(662) 489-6411
(662) 489-8498
Mailing address
278 W 8TH ST, PONTOTOC, MS 38863-3612
(662) 489-6411
(662) 489-8498
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
305
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00230077
—
MS
Enumeration date
08/15/2006
Last updated
01/15/2015
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