| Covington County Hospital | |
|
1207 S Fir Ave Collins MS 39428-3809 | |
| (601) 698-0263 | |
| Not Available |
| Full Name | Covington County Hospital |
|---|---|
| Speciality | Clinic/Center |
| Location | 1207 S Fir Ave, Collins, Mississippi |
| Authorized Official Name and Position | Anissa L Evans (CREDENTIALING DIRECTOR) |
| Authorized Official Contact | 6016980328 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Covington County Hospital Po Box 2499 Collins MS 39428-2499 Ph: (601) 765-2746 | Covington County Hospital 1207 S Fir Ave Collins MS 39428-3809 Ph: (601) 698-0263 |
| NPI Number | 1831895911 |
|---|---|
| Provider Enumeration Date | 02/01/2023 |
| Last Update Date | 04/12/2023 |
| Certification Date | 04/12/2023 |
| Medicare PECOS PAC ID | 4183517253 |
|---|---|
| Medicare Enrollment ID | O20230315002492 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831895911 | NPI | - | NPPES |
| Provider Name | Jennifer G Trihoulis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699891705 PECOS PAC ID: 9335248426 Enrollment ID: I20070702000276 |
| Provider Name | Kenneth R Daughtrey |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902814361 PECOS PAC ID: 1153552963 Enrollment ID: I20140320000254 |
| Provider Name | Crystal Cloy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548754211 PECOS PAC ID: 2264784818 Enrollment ID: I20181009001333 |
| Provider Name | Charlie Jo Crafton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437872041 PECOS PAC ID: 6204293756 Enrollment ID: I20230529000235 |
| Provider Name | Kimberly Bennett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710681614 PECOS PAC ID: 8325494354 Enrollment ID: I20231027001635 |
Covington County Hospital Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 701 S Holly Ave, Collins, MS 39428 Phone: 601-765-6711 Fax: 601-698-0180 |