Organization
COVINGTON COUNTY HOSPITAL
Active
Other names
CCH Clinic Family Medical
Organization subpart
No
Provider details
NPI number
Authorized official
ANISSA L EVANS (CREDENTIALING DIRECTOR)
(601) 698-0328
Entity
Organization
Contact information
Practice address
301 HOSPITAL BLVD, COLLINS, MS 39428-4225
(601) 765-3180
(601) 765-2808
Mailing address
P.O. BOX 2499, COLLINS, MS 39428-2499
(601) 765-3180
(601) 765-2808
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09015963
—
MS
01
—
25D0864691
CLIA
MS
Enumeration date
06/10/2005
Last updated
05/16/2023
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