Provider Demographics
NPI:1043820426
Name:FORREST COUNTY GENERAL HOSPITAL
Entity Type:Organization
Organization Name:FORREST COUNTY GENERAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTRACT ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:SHIELDS
Authorized Official - Last Name:LOWRIMORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-288-1823
Mailing Address - Street 1:125 S 28TH AVE STE 326
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39401-7152
Mailing Address - Country:US
Mailing Address - Phone:601-288-1823
Mailing Address - Fax:601-288-4360
Practice Address - Street 1:128 HIGHLAND PKWY STE 202
Practice Address - Street 2:
Practice Address - City:PICAYUNE
Practice Address - State:MS
Practice Address - Zip Code:39466-5578
Practice Address - Country:US
Practice Address - Phone:601-358-9422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FORREST COUNTY GENERAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-07-31
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty