| Coastal Family Health Center, Inc - Magnolia School Clinic | |
|
4630 Magnolia St Moss Point MS 39563-2659 | |
| (228) 475-1429 | |
| Not Available |
| Full Name | Coastal Family Health Center, Inc - Magnolia School Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 4630 Magnolia St, 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 |
|---|---|
| Coastal Family Health Center, Inc - Magnolia School Clinic 10467 Corporate Dr Gulfport MS 39503-4634 Ph: (228) 374-2494 | Coastal Family Health Center, Inc - Magnolia School Clinic 4630 Magnolia St Moss Point MS 39563-2659 Ph: (228) 475-1429 |
| NPI Number | 1548711120 |
|---|---|
| Provider Enumeration Date | 10/19/2016 |
| Last Update Date | 08/16/2024 |
| Medicare PECOS PAC ID | 8628989654 |
|---|---|
| Medicare Enrollment ID | O20170710001971 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548711120 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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