Full Name | |
---|---|
Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 104 Carver Drive, Collins, Mississippi |
Authorized Official Name and Position | Kaye Ray (CEO) |
Authorized Official Contact | 6015458700 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Po Box 1729 Hattiesburg MS 39403-1729 Ph: (601) 545-8700 | 104 Carver Drive Collins MS 39428 Ph: (601) 545-8700 |
NPI Number | 1053862524 |
---|---|
Provider Enumeration Date | 10/20/2016 |
Last Update Date | 09/06/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1053862524 | NPI | - | NPPES |
02236381 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Covington County Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 701 S Holly Ave, Collins, MS 39428 Phone: 601-765-6711 Fax: 601-698-0112 | |
Covington County Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1207 S Fir Ave, Collins, MS 39428 Phone: 601-419-7468 | |
Covington County Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 301 Highway 35, Collins, MS 39428 Phone: 601-837-7380 | |