| Coastal Family Health Center, Inc - Bay Waveland Middle School | |
|
600 Pine St Bay St Louis MS 39520-3017 | |
| (228) 374-2494 | |
| Not Available |
| Full Name | Coastal Family Health Center, Inc - Bay Waveland Middle School |
|---|---|
| Speciality | Clinic/Center |
| Location | 600 Pine St, Bay St Louis, Mississippi |
| Authorized Official Name and Position | Angelique 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, Inc - Bay Waveland Middle School 10467 Corporate Dr Gulfport MS 39503-4634 Ph: (228) 374-2494 | Coastal Family Health Center, Inc - Bay Waveland Middle School 600 Pine St Bay St Louis MS 39520-3017 Ph: (228) 374-2494 |
| NPI Number | 1427715044 |
|---|---|
| Provider Enumeration Date | 11/18/2021 |
| Last Update Date | 08/16/2024 |
| Medicare PECOS PAC ID | 8628989654 |
|---|---|
| Medicare Enrollment ID | O20220412001405 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427715044 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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