Organization
EAST MISSISSIPPI STATE HOSPITAL
Active
Parent organization
EAST MISSISSIPPI STATE HOSPITAL
Other names
REGINALD P WHITE NURSING FACILITY
Organization subpart
Yes
Provider details
NPI number
Legal business name
EAST MISSISSIPPI STATE HOSPITAL
Authorized official
MR. WILLIAM HAMRICK ENTREKIN (BUSINESS SERVICES DIRECTOR)
(601) 581-7969
Entity
Organization
Contact information
Practice address
4555 HIGHLAND PARK DRIVE, MERIDIAN, MS 39307-2903
(601) 581-7562
(601) 581-7676
Mailing address
P.O. BOX 4128, WEST STATION, MERIDIAN, MS 39304-4128
(601) 581-7562
(601) 581-7676
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
313M00000X
Nursing Facility/Intermediate Care Facility
1230
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00023122
—
MS
Enumeration date
10/27/2006
Last updated
07/27/2020
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