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10828 Highway 57 Vancleave MS 39565 | |
(228) 826-4711 | |
(228) 826-5929 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 10828 Highway 57, Vancleave, Mississippi |
Authorized Official Name and Position | Joe M Dawsey (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 2288182766 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 475 Biloxi MS 39533 Ph: (228) 818-2766 | 10828 Highway 57 Vancleave MS 39565 Ph: (228) 826-4711 |
NPI Number | 1619908118 |
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Provider Enumeration Date | 07/05/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1619908118 | NPI | - | NPPES |
09011503 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Whole Family Care Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 10404 Tucker Rd, Vancleave, MS 39565 Phone: 228-354-9505 | |