PEARL RIVER COUNTY HOSPITAL (NPI# 1053450320) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053450320 |
| Entity Type | Organization |
| Organization Name | PEARL RIVER COUNTY HOSPITAL |
| Practice Address |
305 West Moody Street Poplarville MS 39470 |
| Mailing Address |
Po Box 392 Poplarville MS 39470 |
| Practice Telephone | 6017954543 |
| Practice Fax Number | 6017954238 |
| Mailing Telephone | 6017954543 |
| Mailing Fax Number | 6017954238 |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2011-09-02 |
| Authorized Official Name | MR. MICHAEL BOLEWARE (ADMINISTRATOR) |
| Authorized Official Telephone | 6017954543 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | 21087 | MS | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00220297 | 05 | |
| MS | BLUE CROSS | 000020560 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881992055 | Pearl River County Hospital | Family Medicine | 104 Highway 589, Purvis, MS 39475 | 2011-03-11 |
| 1992915607 | Pearl River County Hospital | Medicare Defined Swing Bed Unit | 305 West Moody Street, Poplarville, MS 39470 | 2007-05-23 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PEARL RIVER COUNTY HOSPITAL & NURSING HOME | 305 West Moody St, Poplarville, MS 39470-7338 |
| Street Address |
305 WEST MOODY STREET |
| City | POPLARVILLE |
| State | MS |
| Zip Code | 39470 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992915607 | Pearl River County Hospital | Medicare Defined Swing Bed Unit | 305 West Moody Street, Poplarville, MS 39470 | 2007-05-23 |
| 1740329341 | Forrest County General Hospital | Nursing Facility/Intermediate Care Facility | 305 West Moody Street, Poplarville, MS 39470 | 2007-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134735723 | Clarence Donald Case Jr. | Psychologist | Pearl River Family and Behavioral Health Clinic, 302 Hwy 11 S, Poplarville, MS 39470 | 2020-09-18 |
| 1285061895 | Freds Stores of Tennessee Inc | Pharmacy | 1388 South Main Street, Poplarville, MS 39470 | 2013-09-27 |
| 1972814127 | Grace Healthcare Dme | Durable Medical Equipment & Medical Supplies | 300 Highway 11, Suite D, Poplarville, MS 39470 | 2010-06-23 |
| 1881837128 | Cirila Reyes | Family Medicine | 1222 S Main Street, Poplarville Family Medical Clinic, Poplarville, MS 39470 | 2009-04-16 |
| 1003026717 | Forrest County General Hospital | General Acute Care Hospital | 305 W Moody St, Poplarville, MS 39470 | 2007-05-23 |
| 1306983903 | Stone County Hospital, Inc. | Clinic/Center | 1222 S Main, Poplarville, MS 39470 | 2007-01-31 |
| 1669527503 | Kelvie Culpepper | Chiropractor | 859 Hwy 26 West, Poplarville, MS 39470 | 2007-01-23 |
| 1669575668 | Michael Frank De Marco | Podiatrist | 101 Lamar Smith Rd, Poplarville, MS 39470 | 2006-09-06 |
| 1831209477 | Ryan W Woods | Physical Therapist | 1403 South Main Street, Suite E, Poplarville, MS 39470 | 2006-08-30 |
| 1316336993 | Allison Sutton | Social Worker | 302 Highway 11 S, Poplarville, MS 39470 | 2015-01-20 |
| Find all providers in zip 39470 | ||||
| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528376217 | Pearl River County Hospital Emergency Department | General Acute Care Hospital | 305 W Moody St, Poplarville, MS 39470-7338 | 2010-09-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184073181 | 81msgs/sgcq | General Acute Care Hospital | 81msgs/sgcq, 301 Fisher St, Rm 5a127, Keesler Afb, MS 39534 | 2016-06-09 |
| 1013396290 | Martin Hillard Mcmullan | General Acute Care Hospital | 2350 Cooper Rd, Flowood, MS 39232-6136 | 2015-05-21 |
| 1750771580 | Genesis Rehab | General Acute Care Hospital | 438 North St, Union, MS 39365-9506 | 2015-02-02 |
| 1003229469 | Robert J Cole | General Acute Care Hospital | 601 Meadowbrook Cir, Amory, MS 38821-1314 | 2014-06-03 |
| 1295151850 | Mary A. Doss | General Acute Care Hospital | 110 Napoleon Dr, Brandon, MS 39047-9004 | 2014-03-06 |
| 1467755744 | Biloxi Regional Medical Center | General Acute Care Hospital | 1104 Homestead Blvd, Gautier, MS 39553-4612 | 2010-12-08 |
| 1528371119 | University Physicians. Pllc | General Acute Care Hospital | 121 Beaufort Cir, Madison, MS 39110-7962 | 2010-07-23 |
| 1306047436 | Alliance Healthcare System | General Acute Care Hospital | 1430 Hwy4-east, Holly Springs, MS 38635 | 2007-05-29 |
| 1518168624 | Alliance Healthcare System | General Acute Care Hospital | 1430 Hwy 4 East, Holly Springs, MS 38635 | 2007-05-29 |
| 1043427206 | Alliance Healthcare System, Inc | General Acute Care Hospital | 1430 Highway 4 E, Holly Springs, MS 38635-2140 | 2007-05-17 |
| Find all providers with the same taxonomy | ||||
| City | POPLARVILLE |
| Zip Code | 39470 |
Please comment or provide details below to improve the information on PEARL RIVER COUNTY HOSPITAL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.