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PEARL RIVER COUNTY HOSPITAL & NURSING HOME

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Company Details

Name: PEARL RIVER COUNTY HOSPITAL & NURSING HOME
Jurisdiction: MISSISSIPPI
Business Type: Non Profit Corporation
Status: Good Standing
Effective Date: 12 Dec 1922 (102 years ago)
Business ID: 111916
ZIP code: 39470
County: Pearl River
State of Incorporation: MISSISSIPPI
Principal Office Address: 305 West Moody Street;PO Box 392Poplarville, MS 39470
Historical names: PEARL RIVER COUNTY HOSPITAL

Agent

Name Role Address
Williams, James Agent 305 West Moody Street, Poplarville, MS 39470

Incorporator

Name Role Address
E C MOODY Incorporator P, POPLARVILLE, MS
GUSSIE JOHNSON Incorporator P, POPLARVILLE, MS
J W MOODY Incorporator P, POPLARVILLE, MS

Member

Name Role Address
Mike Boleware Member 305 West Moody Street, Poplarville, MS 39470

National Provider Identifier

NPI Number:
1881992055

Authorized Person:

Name:
DR. CHARLES GRIFFITH
Role:
PHYSICIAN
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Filings

Type Status Filed Date Description
Amendment Form Filed 2018-11-16 Amendment For PEARL RIVER COUNTY HOSPITAL
Amendment Form Filed 2017-09-22 Amendment For PEARL RIVER COUNTY HOSPITAL
Amendment Form Filed 2013-12-09 Amendment
Formation Form Filed 2011-07-07 Formation
Undetermined Event Filed 1922-12-15 Undetermined Event
Name Reservation Form Filed 1922-12-12 Name Reservation

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Date of last update: 05 Jun 2025

Sources: Company Profile on Mississippi Secretary of State Website