Organization
SOUTH MISSISSIPPI STATE HOSPITAL
Active
Other names
SOUTH MISSISSIPPI STATE HOSPITAL
Organization subpart
No
Provider details
NPI number
Authorized official
CLINT ASHLEY (HOSPITAL DIRECTOR)
(601) 794-0152
Entity
Organization
Contact information
Practice address
823 HIGHWAY 589, PURVIS, MS 39475-4194
(601) 794-0201
(601) 794-0220
Mailing address
823 HIGHWAY 589, PURVIS, MS 39475-4194
(601) 794-0201
(601) 794-0220
Taxonomy
Speciality
Code
Description
License number
State
3336I0012X
Institutional Pharmacy
Primary
04871/3.1
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2046299
PK
—
Enumeration date
01/03/2007
Last updated
11/02/2016
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