Family Health Care Clinic, Inc. | |
102 Blackmur Dr Water Valley MS 38965 | |
(662) 473-2547 | |
Not Available |
Full Name | Family Health Care Clinic, Inc. |
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Speciality | Clinic/Center |
Location | 102 Blackmur Dr, Water Valley, 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. 102 Blackmur Dr Water Valley MS 38965 Ph: (662) 473-2547 |
NPI Number | 1083087985 |
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Provider Enumeration Date | 11/02/2015 |
Last Update Date | 04/16/2020 |
Medicare PECOS PAC ID | 5395656946 |
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Medicare Enrollment ID | O20160121001626 |
Identifier | Type | State | Issuer |
---|---|---|---|
1083087985 | NPI | - | NPPES |
08784312 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Mississippi) | Primary |
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