Organization
SOUTH CENTRAL REGIONAL MEDICAL CENTER
Active
Other names
South Central Regional Medical Center- A&D
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) 426-4228
Mailing address
PO BOX 607, LAUREL, MS 39441-0607
(601) 399-6103
(601) 399-6254
Taxonomy
Speciality
Code
Description
License number
State
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
Primary
11153
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000020141
BLUE CROSS
MS
Enumeration date
08/18/2006
Last updated
04/23/2008
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