| Claiborne County Family Health Center, Inc. | |
|
2045 Highway 61 N Port Gibson MS 39150-4262 | |
| (601) 437-3049 | |
| (601) 437-3051 |
| Full Name | Claiborne County Family Health Center, Inc. |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 2045 Highway 61 N, Port Gibson, Mississippi |
| Authorized Official Name and Position | Coney L Johnson (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 6014373052 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Claiborne County Family Health Center, Inc. Po Box 741 Port Gibson MS 39150-0741 Ph: (601) 437-3049 | Claiborne County Family Health Center, Inc. 2045 Highway 61 N Port Gibson MS 39150-4262 Ph: (601) 437-3049 |
| NPI Number | 1194968982 |
|---|---|
| Provider Enumeration Date | 04/09/2009 |
| Last Update Date | 04/09/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194968982 | NPI | - | NPPES |
| 09013386 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (Mississippi) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Mississippi) | Primary |