Family Health Care Clinic, Inc | |
1732 Commerce St Grenada MS 38901 | |
(601) 825-7280 | |
(601) 825-8130 |
Full Name | Family Health Care Clinic, Inc |
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Speciality | Clinic/Center |
Location | 1732 Commerce St, Grenada, Mississippi |
Authorized Official Name and Position | Karina Marie Clayton (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 6018257280 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Family Health Care Clinic, Inc Po Box 24116 Jackson MS 39225-4116 Ph: (601) 825-7280 | Family Health Care Clinic, Inc 1732 Commerce St Grenada MS 38901 Ph: (601) 825-7280 |
NPI Number | 1629224696 |
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Provider Enumeration Date | 08/11/2008 |
Last Update Date | 07/04/2018 |
Medicare PECOS PAC ID | 5395656946 |
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Medicare Enrollment ID | O20080916000502 |
Identifier | Type | State | Issuer |
---|---|---|---|
1629224696 | NPI | - | NPPES |
08826581 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Mississippi) | Primary |
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