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PRENTISS REGIONAL HOSPITAL AND EXTENDED CARE FACILITY, INC.

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Company Details

Name: PRENTISS REGIONAL HOSPITAL AND EXTENDED CARE FACILITY, INC.
Jurisdiction: MISSISSIPPI
Business Type: Non Profit Corporation
Status: Good Standing
Effective Date: 07 May 1997 (28 years ago)
Business ID: 642186
State of Incorporation: MISSISSIPPI

Agent

Name Role Address
Magee, Reggie Agent 28 Reggie Magee Lane, Mount Olive, MS 39119

Incorporator

Name Role Address
MARLAN L ROBERTS Incorporator 1321 SEBRON ST, P O BOX 820, PRENTISS, MS 39474
RALPH M FORTENBERRY Incorporator BOX 959 HWY 42, PRENTISS, MS 39474

National Provider Identifier

NPI Number:
1043241946

Authorized Person:

Name:
MRS. MARY CURTIS
Role:
CEO
Phone:

Taxonomy:

Selected Taxonomy:
261QR1300X - Rural Health Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
6017922947

Filings

Type Status Filed Date Description
Amendment Form Filed 2011-06-29 Amendment
Name Reservation Form Filed 1997-05-07 Name Reservation

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Date of last update: 01 May 2025

Sources: Company Profile on Mississippi Secretary of State Website