Provider Demographics
NPI:1306983903
Name:STONE COUNTY HOSPITAL, INC.
Entity type:Organization
Organization Name:STONE COUNTY HOSPITAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:ROONEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:601-928-6700
Mailing Address - Street 1:PO BOX 345
Mailing Address - Street 2:
Mailing Address - City:WIGGINS
Mailing Address - State:MS
Mailing Address - Zip Code:39577
Mailing Address - Country:US
Mailing Address - Phone:601-928-6700
Mailing Address - Fax:601-982-6731
Practice Address - Street 1:1222 S MAIN
Practice Address - Street 2:
Practice Address - City:POPLARVILLE
Practice Address - State:MS
Practice Address - Zip Code:39470
Practice Address - Country:US
Practice Address - Phone:601-795-9320
Practice Address - Fax:601-795-9876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS261QC0050X261QC0050X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC0050XAmbulatory Health Care FacilitiesClinic/CenterCritical Access Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00113988Medicaid
MS00113988Medicaid