Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | 547 Front St., Weir, Mississippi |
Authorized Official Name and Position | Ray Shoemaker (ADMINISTRATOR) |
Authorized Official Contact | 6622856235 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 1039 Ackerman MS 39735-1039 Ph: (662) 285-6235 | 547 Front St. Weir MS 39772 Ph: (662) 547-9697 |
NPI Number | 1982659405 |
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Provider Enumeration Date | 05/23/2006 |
Last Update Date | 07/09/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1982659405 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |