| Coastal Family Health Center | |
|
109 Hospital Dr Bay St Louis MS 39520-1604 | |
| (228) 463-9666 | |
| (228) 374-0856 |
| Full Name | Coastal Family Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 109 Hospital Dr, Bay St Louis, 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 |
|---|---|
| Coastal Family Health Center 10467 Corporate Dr Gulfport MS 39503-4634 Ph: (228) 374-2494 | Coastal Family Health Center 109 Hospital Dr Bay St Louis MS 39520-1604 Ph: (228) 463-9666 |
| NPI Number | 1124016209 |
|---|---|
| Provider Enumeration Date | 10/12/2005 |
| Last Update Date | 08/16/2024 |
| Medicare PECOS PAC ID | 8628989654 |
|---|---|
| Medicare Enrollment ID | O20081002000153 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124016209 | NPI | - | NPPES |
| C00895 | Other | MS | MEDICARE/CAHABA |
| 9014820 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Mississippi) | Primary |
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