| |
6312 Martin Luther King Blvd Moss Point MS 39563-6126 | |
(228) 475-3719 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 6312 Martin Luther King Blvd, Moss Point, 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 |
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10467 Corporate Dr Gulfport MS 39503-4634 Ph: (228) 374-2494 | 6312 Martin Luther King Blvd Moss Point MS 39563-6126 Ph: (228) 475-3719 |
NPI Number | 1306343694 |
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Provider Enumeration Date | 04/12/2018 |
Last Update Date | 08/16/2024 |
Medicare PECOS PAC ID | 8628989654 |
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Medicare Enrollment ID | O20180522000711 |
Identifier | Type | State | Issuer |
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1306343694 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Gale Primary Care, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3702 Jefferson Ave, Moss Point, MS 39563 Phone: 228-641-1674 Fax: 228-205-4593 | |
Allgood Family Medical Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9930 Saracennia Rd, Moss Point, MS 39562 Phone: 228-475-7877 Fax: 228-475-8085 | |
Moss Point Family Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5430 Griffin St, Moss Point, MS 39563 Phone: 228-355-0719 Fax: 228-475-4039 | |