Elite Care Family Medicine, Llc | |
571 Mitchell St Ste C Guntown MS 38849-8500 | |
(662) 255-8324 | |
(662) 348-2772 |
Full Name | Elite Care Family Medicine, Llc |
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Speciality | Clinic/Center |
Location | 571 Mitchell St, Guntown, Mississippi |
Authorized Official Name and Position | Kevin Miller (CO OWNER) |
Authorized Official Contact | 6623483342 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Elite Care Family Medicine, Llc 571 Mitchell St Ste C Guntown MS 38849-8500 Ph: (662) 348-3342 | Elite Care Family Medicine, Llc 571 Mitchell St Ste C Guntown MS 38849-8500 Ph: (662) 255-8324 |
NPI Number | 1194128306 |
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Provider Enumeration Date | 10/01/2014 |
Last Update Date | 04/19/2023 |
Medicare PECOS PAC ID | 7214256601 |
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Medicare Enrollment ID | O20150506002292 |
Identifier | Type | State | Issuer |
---|---|---|---|
1194128306 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | 342 (Mississippi) | Primary |
Provider Name | Lori Cleo Harris |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1811168578 PECOS PAC ID: 4082784327 Enrollment ID: I20080529000577 |
Provider Name | Kevin S Miller |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1588097471 PECOS PAC ID: 2365670031 Enrollment ID: I20140103000010 |
Provider Name | Hannah Reeves |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1932737202 PECOS PAC ID: 9830508076 Enrollment ID: I20210429001361 |
Provider Name | Fulumirani Mccoy |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1598438483 PECOS PAC ID: 0143603340 Enrollment ID: I20220822001410 |
Provider Name | Ashlyn Elena Stevens |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1306615398 PECOS PAC ID: 6204274764 Enrollment ID: I20240402004457 |