Organization
LEAKE COUNTY BOARD OF TRUSTEES
Active
Other names
Leake Memorial Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT DANIEL FAULKNER (ADMINISTRATOR)
(601) 267-1432
Entity
Organization
Contact information
Practice address
310 ELLIS ST, CARTHAGE, MS 39051-3809
(601) 267-1100
(601) 267-1211
Mailing address
310 ELLIS ST, CARTHAGE, MS 39051-3809
(601) 267-1100
(601) 267-1211
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
11-187
MS
282NC0060X
Critical Access Hospital
Primary
11-187
MS
282NR1301X
Rural Acute Care Hospital
11-187
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0220808
—
MS
05
—
0220809
—
MS
05
—
0230186
—
MS
05
—
9016232
—
MS
05
—
9016253
—
MS
Enumeration date
12/13/2005
Last updated
12/30/2008
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