National Provider Identifier Database

JEFFERSON COUNTY HOSPITAL
Rural


Contact Information

JEFFERSON COUNTY HOSPITAL
870 SOUTH MAIN STREET
FAYETTE, MS39069-0577
Phone: 601-786-3401
Fax: 601-786-3400
Website:
Specialty Taxonomy Code
* Rural 282NR1301X
General Acute Care Hospital 282N00000X
Psychiatric Unit 273R00000X

* Indicates primary specialty

NPI Profile & details for JEFFERSON COUNTY HOSPITAL

NPI Number 1043204555
Legal business name
LBN
JEFFERSON COUNTY HOSPITAL
Authorized official JERRY KENNEDY - (INTERM CEO)
Entity Organization
Organization subpart No
Enumeration date 09/12/2005
Last updated 03/22/2024 - About 2 years ago
Sole proprietor1 Not specified
Identifiers
  • MS License #: 21238
  • MS Other: C02109 BLUE CROSS BLUE SHIELD

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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