Provider Demographics
NPI:1447431101
Name:GREENE COUNTY HOSPITAL, INC.
Entity Type:Organization
Organization Name:GREENE COUNTY HOSPITAL, INC.
Other - Org Name:GREENE COUNTY HOSPITAL
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:KULUZ
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:601-928-2911
Mailing Address - Street 1:PO BOX 115
Mailing Address - Street 2:
Mailing Address - City:WIGGINS
Mailing Address - State:MS
Mailing Address - Zip Code:39577-0115
Mailing Address - Country:US
Mailing Address - Phone:601-928-2911
Mailing Address - Fax:
Practice Address - Street 1:1017 JACKSON AVE
Practice Address - Street 2:
Practice Address - City:LEAKESVILLE
Practice Address - State:MS
Practice Address - Zip Code:39451-9105
Practice Address - Country:US
Practice Address - Phone:601-394-2371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-21
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSIN PROCESS282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access