Central Mississippi Civic Improvement Association, Inc. | |
417 Palestine St Raymond MS 39154-7618 | |
(601) 362-5321 | |
Not Available |
Full Name | Central Mississippi Civic Improvement Association, Inc. |
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Speciality | Clinic/Center |
Location | 417 Palestine St, Raymond, Mississippi |
Authorized Official Name and Position | Jasmin Chapman (CEO) |
Authorized Official Contact | 6013645142 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Central Mississippi Civic Improvement Association, Inc. 3502 W Northside Dr Jackson MS 39213-4454 Ph: (601) 362-5321 | Central Mississippi Civic Improvement Association, Inc. 417 Palestine St Raymond MS 39154-7618 Ph: (601) 362-5321 |
NPI Number | 1023586609 |
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Provider Enumeration Date | 11/13/2018 |
Last Update Date | 12/12/2023 |
Medicare PECOS PAC ID | 4183533235 |
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Medicare Enrollment ID | O20190123002798 |
Identifier | Type | State | Issuer |
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1023586609 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Central Mississippi Civic Improvement Association, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 14050 Highway 18, Raymond, MS 39154 Phone: 601-362-5321 Fax: 601-364-5159 | |
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