| Christ Community Health Services Inc | |
|
1104 Whitehall St Jackson TN 38301-3730 | |
| (731) 213-6899 | |
| (731) 215-2501 |
| Full Name | Christ Community Health Services Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1104 Whitehall St, Jackson, Tennessee |
| Authorized Official Name and Position | Shantelle Leatherwood (CEO) |
| Authorized Official Contact | 9018423160 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Christ Community Health Services Inc 2595 Central Ave Memphis TN 38104-5905 Ph: (901) 842-3160 | Christ Community Health Services Inc 1104 Whitehall St Jackson TN 38301-3730 Ph: (731) 213-6899 |
| NPI Number | 1871299297 |
|---|---|
| Provider Enumeration Date | 02/07/2023 |
| Last Update Date | 06/21/2023 |
| Medicare PECOS PAC ID | 3870402084 |
|---|---|
| Medicare Enrollment ID | O20230724002558 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871299297 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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