| Covington County Hospital | |
|
701 S Holly Ave Collins MS 39428-3894 | |
| (601) 765-6711 | |
| (601) 698-0180 |
| Full Name | Covington County Hospital |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 701 S Holly Ave, Collins, Mississippi |
| Authorized Official Name and Position | Gregg Gibbes (CEO) |
| Authorized Official Contact | 6016980101 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Covington County Hospital Po Box 1149 Collins MS 39428-1149 Ph: (601) 765-6711 | Covington County Hospital 701 S Holly Ave Collins MS 39428-3894 Ph: (601) 765-6711 |
| NPI Number | 1225150436 |
|---|---|
| Provider Enumeration Date | 04/06/2007 |
| Last Update Date | 06/03/2022 |
| Certification Date | 06/03/2022 |
| Medicare PECOS PAC ID | 4183517253 |
|---|---|
| Medicare Enrollment ID | O20080912000376 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225150436 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | (* (Not Available)) | Primary |
| Provider Name | Brian H Gordon |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1871818369 PECOS PAC ID: 3577751528 Enrollment ID: I20101217000553 |
| Provider Name | Kenneth R Daughtrey |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902814361 PECOS PAC ID: 1153552963 Enrollment ID: I20140320000254 |
Covington Place: Therapy & Counseling Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1207 S Fir Ave, Collins, MS 39428 Phone: 601-698-0263 |