| Family Health Center Inc | |
|
5192 Highway 11 N Ellisville MS 39437-5050 | |
| (601) 425-3033 | |
| (601) 428-6561 |
| Full Name | Family Health Center Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5192 Highway 11 N, Ellisville, Mississippi |
| Authorized Official Name and Position | Coney Lee Johnson (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 6014253033 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Health Center Inc P O Box 4361 117 South 11th Avenue Laurel MS 39441 Ph: (601) 425-3033 | Family Health Center Inc 5192 Highway 11 N Ellisville MS 39437-5050 Ph: (601) 425-3033 |
| NPI Number | 1083255087 |
|---|---|
| Provider Enumeration Date | 10/01/2019 |
| Last Update Date | 01/17/2020 |
| Medicare PECOS PAC ID | 9638163348 |
|---|---|
| Medicare Enrollment ID | O20200115002442 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083255087 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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