Provider Demographics
NPI:1134616113
Name:NOXUBEE GENERAL CRITICAL ACCESS HOSPITAL
Entity type:Organization
Organization Name:NOXUBEE GENERAL CRITICAL ACCESS HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:H
Authorized Official - Last Name:MCKAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-726-4231
Mailing Address - Street 1:PO BOX 480
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:MS
Mailing Address - Zip Code:39341
Mailing Address - Country:US
Mailing Address - Phone:662-726-4231
Mailing Address - Fax:662-726-9006
Practice Address - Street 1:34 HOSPITAL ROAD
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:MS
Practice Address - Zip Code:39341
Practice Address - Country:US
Practice Address - Phone:662-788-4398
Practice Address - Fax:662-788-4399
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NOXUBEE GENERAL CRITICAL ACCESS HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-04-16
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
170203336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy