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CAH251333-00 PEARL RIVER COUNTY HOSPITAL (Active)
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Main Details
Name
PEARL RIVER COUNTY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH251333-00
Medicare Provider Number
251333
Additional Details
Current Program Status
Active
Registration Date
2/15/2011
Participating Start Date
4/1/2011
Participating Approval Date
3/15/2011
Last Recertification Date
9/3/2024
Contacts
Authorizing Official
Forrest General Hospital
Ben Hester, CFO
(601) 288-4225
Primary Contact
Pearl River Community Hospital
Gerald Vance, Chief Pharmacist
(601) 240-2042
Addresses
Street Address
305 W. MOODY STREET
POPLARVILLE, MS 39470
Billing Address
PEARL RIVER COUNTY HOSPITAL
P. O. BOX 392
POPLARVILLE, MS 39470
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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