Provider Demographics
NPI:1750895611
Name:COVINGTON COUNTY HOSPITAL
Entity type:Organization
Organization Name:COVINGTON COUNTY HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL STAFF COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANISSA
Authorized Official - Middle Name:L
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-765-3180
Mailing Address - Street 1:701 S HOLLY AVE
Mailing Address - Street 2:
Mailing Address - City:COLLINS
Mailing Address - State:MS
Mailing Address - Zip Code:39428-3894
Mailing Address - Country:US
Mailing Address - Phone:601-849-1918
Mailing Address - Fax:601-849-1908
Practice Address - Street 1:800 3RD ST SW
Practice Address - Street 2:
Practice Address - City:MAGEE
Practice Address - State:MS
Practice Address - Zip Code:39111-3951
Practice Address - Country:US
Practice Address - Phone:601-849-1918
Practice Address - Fax:601-849-1908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-29
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health