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CAH251300-00 INDEPENDENT HEALTHCARE MANAGMENT, INC. D/B/A SE LACKEY MEMORIAL HOSPITAL (Active)
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Main Details
Name
INDEPENDENT HEALTHCARE MANAGMENT, INC. D/B/A SE LACKEY MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH251300-00
Medicare Provider Number
251300
Additional Details
Current Program Status
Active
Registration Date
11/30/2010
Participating Start Date
1/1/2011
Participating Approval Date
11/30/2010
Last Recertification Date
8/29/2024
Contacts
Authorizing Official
Lackey Memorial Hospital
sydney sawyer, ceo
(601) 469-4151 Ext: 301
Primary Contact
Lackey Memorial Hospital - Magee, MS
Carol Denton, Integrity Officer/Privacy & Security
(601) 209-3483
Addresses
Street Address
330 N. BROAD ST.
FOREST, MS 39074
Billing Address
Independent Healthcare Management
PO BOX 1460
MAGEE, MS 39111
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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