Organization
BEDFORD CARE CENTER OF HATTIESBURG, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVE A. WORREL (CONTROLLER)
(601) 583-3232
Entity
Organization
Contact information
Practice address
10 MEDICAL BLVD, HATTIESBURG, MS 39401-7230
(601) 264-3709
(601) 264-1144
Mailing address
100 W PINE ST, HATTIESBURG, MS 39401-3467
(601) 583-3232
(601) 582-7539
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
237
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000080352
BCBS PROVIDER NUMBER
MS
05
—
00230158
—
MS
Enumeration date
11/15/2005
Last updated
01/15/2010
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