NPIMap

Organization Active NPI

Pearl River County Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Poplarville, MS
National Provider Identifier
1992915607
Registry record updated Sep 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
21087 Issued in MS
Legal business name
PEARL RIVER COUNTY HOSPITAL
Practice address
305 West Moody Street
Poplarville, MS 39470
Phone
(601) 795-4543
Fax
(601) 795-4238
NPI assigned
May 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Michael Boleware
Title
Administrator
Phone
(601) 795-4543

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 21087 MS Primary

Addresses

Primary practice location

305 West Moody Street
Poplarville, MS 39470

Mailing address

PO Box 392
Poplarville, MS 39470
Phone (601) 795-4543

Other identifiers 2

IdentifierTypeStateIssuer
000080560OtherBLUE CROSS SWING BED
00220509MedicaidMS

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

207 W Pearl St
Poplarville, MS 39470

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314921600000",
    "number": "1992915607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 392",
            "city": "POPLARVILLE",
            "state": "MS",
            "postal_code": "39470",
            "telephone_number": "601-795-4543",
            "fax_number": "601-795-4238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 WEST MOODY STREET",
            "city": "POPLARVILLE",
            "state": "MS",
            "postal_code": "39470",
            "telephone_number": "601-795-4543",
            "fax_number": "601-795-4238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEARL RIVER COUNTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2011-09-02",
        "status": "A",
        "authorized_official_last_name": "BOLEWARE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "601-795-4543",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "MS",
            "license": "21087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS SWING BED",
            "identifier": "000080560",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00220509",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poplarville, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.