Family Health Care Clinic, Inc. | |
150 J E Johnson Rd Prentiss MS 39474-3101 | |
(601) 825-7280 | |
(601) 825-8130 |
Full Name | Family Health Care Clinic, Inc. |
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Speciality | Clinic/Center |
Location | 150 J E Johnson Rd, Prentiss, 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. 150 J E Johnson Rd Prentiss MS 39474-3101 Ph: (601) 825-7280 |
NPI Number | 1639644826 |
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Provider Enumeration Date | 10/04/2018 |
Last Update Date | 10/04/2018 |
Medicare PECOS PAC ID | 5395656946 |
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Medicare Enrollment ID | O20200820003173 |
Identifier | Type | State | Issuer |
---|---|---|---|
1639644826 | NPI | - | NPPES |
NONE | Other | MS | NONE |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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Family Health Care Clinic, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 910 Second Street, Prentiss, MS 39474 Phone: 601-792-2078 Fax: 601-792-8211 | |
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