| Family Care Clinic, Pllc | |
|
1440 Highway 1 S Greenville MS 38701-7140 | |
| (662) 820-7780 | |
| (888) 980-6547 |
| Full Name | Family Care Clinic, Pllc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1440 Highway 1 S, Greenville, Mississippi |
| Authorized Official Name and Position | Lamonica Antonette Hodges (OWNER/ADMINISTRATOR) |
| Authorized Official Contact | 6628207780 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Care Clinic, Pllc Po Box 3946 Greenville MS 38704-3946 Ph: (662) 820-7780 | Family Care Clinic, Pllc 1440 Highway 1 S Greenville MS 38701-7140 Ph: (662) 820-7780 |
| NPI Number | 1124481791 |
|---|---|
| Provider Enumeration Date | 04/01/2016 |
| Last Update Date | 04/01/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124481791 | NPI | - | NPPES |
| 09551264 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 901388 (Mississippi) | Primary |
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