Provider Demographics
NPI:1386654309
Name:STONE COUNTY HOSPITAL, INC.
Entity Type:Organization
Organization Name:STONE COUNTY HOSPITAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-928-5004
Mailing Address - Street 1:1434 CENTRAL AVE E
Mailing Address - Street 2:P O DRAWER 97
Mailing Address - City:WIGGINS
Mailing Address - State:MS
Mailing Address - Zip Code:39577-9602
Mailing Address - Country:US
Mailing Address - Phone:601-928-6600
Mailing Address - Fax:601-928-6658
Practice Address - Street 1:1434 CENTRAL AVE E
Practice Address - Street 2:P O DRAWER 97
Practice Address - City:WIGGINS
Practice Address - State:MS
Practice Address - Zip Code:39577-9602
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:2006-08-09
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS12280282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS09278803Medicaid
MS00019707OtherBLUE CROSS
MS00019707AOtherBLUE CROSS
MS00020707OtherBLUE CROSS
MS00220714Medicaid
MS09015938Medicaid
MS02550263Medicaid
MS00220714Medicaid
MS00020707OtherBLUE CROSS
MS02550263Medicaid