Organization
STONE COUNTY HOSPITAL INC
Active
Other names
POPLARVILLE FAMILY MEDICAL CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
DARLENE C ODOM (BUSINESS OFFICE DIRECTOR)
(601) 928-6620
Entity
Organization
Contact information
Practice address
1434 CENTRAL AVE E, WIGGINS, MS 39577-9602
(601) 928-6600
(601) 928-6658
Mailing address
1434 CENTRAL AVE E, WIGGINS, MS 39577-9602
(601) 928-6600
(601) 928-6658
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
12280
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
258530
TRISPAN RURAL HEALTH CLINIC
MS
Enumeration date
05/30/2008
Last updated
05/30/2008
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