| Desoto Community Health Center | |
|
7535 Airways Blvd Southaven MS 38671-5834 | |
| (662) 349-6220 | |
| Not Available |
| Full Name | Desoto Community Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 7535 Airways Blvd, Southaven, Mississippi |
| Authorized Official Name and Position | Marjorie Mckinney (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6628382163 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Desoto Community Health Center Po Box 698 Byhalia MS 38611-0698 Ph: () - | Desoto Community Health Center 7535 Airways Blvd Southaven MS 38671-5834 Ph: (662) 349-6220 |
| NPI Number | 1447665385 |
|---|---|
| Provider Enumeration Date | 06/30/2014 |
| Last Update Date | 06/30/2014 |
| Medicare PECOS PAC ID | 5294717377 |
|---|---|
| Medicare Enrollment ID | O20140723000068 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447665385 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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