Organization
VICKSBURG HEALTHCARE LLC
Active
Organization
VICKSBURG HEALTHCARE LLC
Active
Parent organization
VICKSBURG HEALTHCARE LLC
Other names
Merit Health River Region West
Organization subpart
Yes
Provider details
NPI number
Legal business name
VICKSBURG HEALTHCARE LLC
Authorized official
PAULA M LALOR (DIRECTOR/DELEGATED OFFICIAL)
(629) 215-3953
Entity
Organization
Contact information
Practice address
1111 N FRONTAGE RD, VICKSBURG, MS 39180-5102
(601) 883-5000
(601) 883-3090
Mailing address
PO BOX 841672, DALLAS, TX 75284-1672
(601) 883-5000
(601) 883-3090
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1749079
—
MS
Enumeration date
06/02/2006
Last updated
04/22/2021
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