Organization
SOUTH CENTRAL REG MED CTR - VFC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES T CANIZARO (CFO)
(601) 426-4504
Entity
Organization
Contact information
Practice address
1220 JEFFERSON ST, LAUREL, MS 39440-4355
(601) 426-4000
(601) 399-6254
Mailing address
PO BOX 607, LAUREL, MS 39441-0607
(601) 426-4000
(601) 399-6254
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
11-153
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01329295
—
MS
Enumeration date
12/13/2007
Last updated
12/13/2007
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