Provider Demographics
NPI:1225704208
Name:COVINGTON COUNTY HOSPITAL
Entity Type:Organization
Organization Name:COVINGTON COUNTY HOSPITAL
Other - Org Name:FAMILY CARE MAGEE TUSCAN TOWERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANISSA
Authorized Official - Middle Name:L
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-698-0328
Mailing Address - Street 1:360 SIMPSON HIGHWAY 149 STE 370
Mailing Address - Street 2:
Mailing Address - City:MAGEE
Mailing Address - State:MS
Mailing Address - Zip Code:39111-3843
Mailing Address - Country:US
Mailing Address - Phone:601-849-1530
Mailing Address - Fax:
Practice Address - Street 1:360 SIMPSON HIGHWAY 149 STE 370
Practice Address - Street 2:
Practice Address - City:MAGEE
Practice Address - State:MS
Practice Address - Zip Code:39111-3843
Practice Address - Country:US
Practice Address - Phone:601-849-1530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-19
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health