| Jefferson Davis Community Hospital | |
|
1102 Rose Street Prentiss MS 39474 | |
| (601) 792-4276 | |
| (601) 792-2947 |
| Full Name | Jefferson Davis Community Hospital |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 1102 Rose Street, Prentiss, Mississippi |
| Authorized Official Name and Position | Gary Lee Mccall (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 6017924276 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jefferson Davis Community Hospital Po Box 1288 Prentiss MS 39474-1288 Ph: (601) 792-4276 | Jefferson Davis Community Hospital 1102 Rose Street Prentiss MS 39474 Ph: (601) 792-4276 |
| NPI Number | 1629107990 |
|---|---|
| Provider Enumeration Date | 03/05/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629107990 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 16-179 (Mississippi) | Primary |
Jefferson Davis General Hospital Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1102 Rose St, Prentiss, MS 39474 Phone: 601-792-4276 Fax: 601-792-2947 |