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3446 Popps Ferry Rd Diberville MS 39540-2421 | |
(228) 374-2494 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 3446 Popps Ferry Rd, Diberville, Mississippi |
Authorized Official Name and Position | Angelique S Greer (CEO) |
Authorized Official Contact | 2283742494 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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10467 Corporate Dr Gulfport MS 39503-4634 Ph: (228) 374-2494 | 3446 Popps Ferry Rd Diberville MS 39540-2421 Ph: (228) 374-2494 |
NPI Number | 1629309117 |
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Provider Enumeration Date | 01/22/2010 |
Last Update Date | 08/16/2024 |
Medicare PECOS PAC ID | 8628989654 |
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Medicare Enrollment ID | O20100310000407 |
Identifier | Type | State | Issuer |
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1629309117 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Resolute Healthcare Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4347 W Gay Rd, Diberville, MS 39540 Phone: 228-229-7989 | |
D'iberville Medical Clinic Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11516 Lamey Bridge Rd, Ste 1, Diberville, MS 39540 Phone: 228-207-4190 Fax: 228-207-4190 |