| Trace Regional Hospital | |
|
1002 E Madison St Houston MS 38851-2417 | |
| (662) 456-1163 | |
| (662) 456-1159 |
| Full Name | Trace Regional Hospital |
|---|---|
| Speciality | Clinic/center |
| Location | 1002 E Madison St, Houston, Mississippi |
| Authorized Official Name and Position | Sheila Brockman (CEO) |
| Authorized Official Contact | 6624563700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Trace Regional Hospital Po Box 626 Houston MS 38851-0626 Ph: (662) 456-1163 | Trace Regional Hospital 1002 E Madison St Houston MS 38851-2417 Ph: (662) 456-1163 |
| NPI Number | 1003096488 |
|---|---|
| Provider Enumeration Date | 11/14/2007 |
| Last Update Date | 01/18/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003096488 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 12-296 (Mississippi) | Primary |
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