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301 Hospital Blvd Collins MS 39428-4225 | |
(601) 765-3180 | |
(601) 765-2808 |
Full Name | |
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Speciality | Clinic/Center |
Location | 301 Hospital Blvd, Collins, Mississippi |
Authorized Official Name and Position | Anissa L Evans (CREDENTIALING DIRECTOR) |
Authorized Official Contact | 6016980328 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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P.o. Box 2499 Collins MS 39428-2499 Ph: (601) 765-3180 | 301 Hospital Blvd Collins MS 39428-4225 Ph: (601) 765-3180 |
NPI Number | 1598769044 |
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Provider Enumeration Date | 06/10/2005 |
Last Update Date | 05/16/2023 |
Medicare PECOS PAC ID | 4183517253 |
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Medicare Enrollment ID | O20100812001175 |
Identifier | Type | State | Issuer |
---|---|---|---|
1598769044 | NPI | - | NPPES |
25D0864691 | Other | MS | CLIA |
09015963 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Covington County Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 701 S Holly Ave, Collins, MS 39428 Phone: 601-765-6711 Fax: 601-698-0112 | |
Covington County Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1207 S Fir Ave, Collins, MS 39428 Phone: 601-419-7468 | |
Covington County Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 301 Highway 35, Collins, MS 39428 Phone: 601-837-7380 | |