Provider Demographics
NPI:1497468151
Name:SOUTHWEST MISSISSIPPI REGIONAL MEDICAL CENTER
Entity Type:Organization
Organization Name:SOUTHWEST MISSISSIPPI REGIONAL MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROWLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-249-1806
Mailing Address - Street 1:PO BOX 490
Mailing Address - Street 2:
Mailing Address - City:MCCOMB
Mailing Address - State:MS
Mailing Address - Zip Code:39649-0490
Mailing Address - Country:US
Mailing Address - Phone:601-250-4366
Mailing Address - Fax:601-250-4367
Practice Address - Street 1:1065 E BROAD ST
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:MS
Practice Address - Zip Code:39654-7703
Practice Address - Country:US
Practice Address - Phone:601-587-4051
Practice Address - Fax:601-587-0306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-27
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty