PEARL RIVER COUNTY HOSPITAL (NPI# 1992915607) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992915607 |
| 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 | 2007-05-23 |
| 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 | 275N00000X | Medicare Defined Swing Bed Unit | 21087 | MS | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BLUE CROSS SWING BED | 000080560 | 01 | |
| MS | 00220509 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881992055 | Pearl River County Hospital | Family Medicine | 104 Highway 589, Purvis, MS 39475 | 2011-03-11 |
| 1053450320 | Pearl River County Hospital | General Acute Care Hospital | 305 West Moody Street, Poplarville, MS 39470 | 2007-02-05 |
| 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 |
|---|---|---|---|---|
| 1053450320 | Pearl River County Hospital | General Acute Care Hospital | 305 West Moody Street, Poplarville, MS 39470 | 2007-02-05 |
| 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 | 275N00000X |
| Grouping | Hospital Units |
| Classification | Medicare Defined Swing Bed Unit |
| A unit of a hospital that has a Medicare provider agreement and has been granted approval from HCFA to provide post-hospital extended care services and be reimbursed as a swing-bed unit. |
| Notes: Source: Code of Federal Regulations #42, Section 482.66. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124325287 | Forrest County General Hospital | Medicare Defined Swing Bed Unit | 305 W Moody St, Poplarville, MS 39470-7338 | 2011-02-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568626216 | Guardian Angel Healthcare Inc., II | Medicare Defined Swing Bed Unit | 347 Magnolia Drive, Raleigh, MS 39153 | 2008-07-11 |
| 1487863692 | Kilmichael Hospital | Medicare Defined Swing Bed Unit | 301 Lamar Ave, Kilmichael, MS 39747 | 2007-05-22 |
| 1972620292 | Yalobusha General Hospital | Medicare Defined Swing Bed Unit | 630 South Main Street, Water Valley, MS 38965-3468 | 2007-03-23 |
| 1659404770 | Patients Choice Medical Center of Humphreys County, LLC | Medicare Defined Swing Bed Unit | 500 C C C Rd, Belzoni, MS 39038-3806 | 2007-03-14 |
| 1104904457 | Claiborne County Hospital | Medicare Defined Swing Bed Unit | 123 Mccomb Avenue, Port Gibson, MS 39150-1004 | 2006-11-02 |
| 1972538270 | Tippah County Hospital | Medicare Defined Swing Bed Unit | 1005 City Avenue North, Ripley, MS 38663-0499 | 2006-07-12 |
| 1700872173 | State of Mississippi - University of Mississippi Medical Center | Medicare Defined Swing Bed Unit | 239 Bowling Green Rd, Lexington, MS 39095-5167 | 2005-09-21 |
| 1447253521 | Pioneer Health Services of Newton County, LLC | Medicare Defined Swing Bed Unit | 9421 Eastside Drive Extention, Newton, MS 39345-2613 | 2005-05-23 |
| 1457979908 | Natchez Hospital Company LLC | Medicare Defined Swing Bed Unit | 54 Sergeant Prentiss Dr, Natchez, MS 39120-4726 | 2020-07-10 |
| 1003431602 | State of Mississippi - University of Mississippi Medical Center | Medicare Defined Swing Bed Unit | 960 Avent Dr, Grenada, MS 38901-5230 | 2020-06-10 |
| 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.