Provider Demographics
NPI:1346734373
Name:TALLAHATCHIE GENERAL HOSPITAL
Entity Type:Organization
Organization Name:TALLAHATCHIE GENERAL HOSPITAL
Other - Org Name:TGH DISCOUNT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS OFFICE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:RENE
Authorized Official - Last Name:VEST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-625-7111
Mailing Address - Street 1:109 W WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:MS
Mailing Address - Zip Code:38921-2242
Mailing Address - Country:US
Mailing Address - Phone:662-647-5172
Mailing Address - Fax:
Practice Address - Street 1:109 W WALNUT ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:MS
Practice Address - Zip Code:38921-2242
Practice Address - Country:US
Practice Address - Phone:662-647-5172
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TALLAHATCHIE GENERAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-06-22
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy