Bmc Leake Carthage Primary Care | |
1100 Hwy 16 East Carthage MS 39051-3809 | |
(601) 267-1470 | |
(601) 267-1469 |
Full Name | Bmc Leake Carthage Primary Care |
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Speciality | Clinic/Center |
Location | 1100 Hwy 16 East, Carthage, Mississippi |
Authorized Official Name and Position | Gregory M Duckett (SR VP/CLO) |
Authorized Official Contact | 9012275233 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Bmc Leake Carthage Primary Care 350 N Humphreys Blvd Memphis TN 38120-2177 Ph: (601) 267-1470 | Bmc Leake Carthage Primary Care 1100 Hwy 16 East Carthage MS 39051-3809 Ph: (601) 267-1470 |
NPI Number | 1194861260 |
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Provider Enumeration Date | 01/29/2007 |
Last Update Date | 04/29/2022 |
Medicare PECOS PAC ID | 7214102961 |
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Medicare Enrollment ID | O20111208000595 |
Identifier | Type | State | Issuer |
---|---|---|---|
1194861260 | NPI | - | NPPES |
09016232 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | 11187 (Mississippi) | Primary |
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