| Access School Health - Pontotoc Main | |
|
135 E Oxford St Pontotoc MS 38863-2111 | |
| (662) 489-3336 | |
| Not Available |
| Full Name | Access School Health - Pontotoc Main |
|---|---|
| Speciality | Clinic/Center |
| Location | 135 E Oxford St, Pontotoc, Mississippi |
| Authorized Official Name and Position | Marilyn Sumerford (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6626514686 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Access School Health - Pontotoc Main Po Box 305 Smithville MS 38870-0305 Ph: (662) 651-4637 | Access School Health - Pontotoc Main 135 E Oxford St Pontotoc MS 38863-2111 Ph: (662) 489-3336 |
| NPI Number | 1366004657 |
|---|---|
| Provider Enumeration Date | 07/08/2019 |
| Last Update Date | 08/08/2019 |
| Medicare PECOS PAC ID | 4082509492 |
|---|---|
| Medicare Enrollment ID | O20190909001767 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366004657 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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