Provider Demographics
NPI:1043452493
Name:STONE COUNTY HOSPITAL, INC
Entity Type:Organization
Organization Name:STONE COUNTY HOSPITAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:GAMBLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-928-6600
Mailing Address - Street 1:1434 E CENTRAL AVE.
Mailing Address - Street 2:
Mailing Address - City:WIGGINS
Mailing Address - State:MS
Mailing Address - Zip Code:39577
Mailing Address - Country:US
Mailing Address - Phone:601-928-6600
Mailing Address - Fax:601-928-6658
Practice Address - Street 1:1434 E CENTRAL AVE.
Practice Address - Street 2:
Practice Address - City:WIGGINS
Practice Address - State:MS
Practice Address - Zip Code:39577
Practice Address - Country:US
Practice Address - Phone:601-928-6600
Practice Address - Fax:601-928-6658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-01
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS09382282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural