| Fhc Waynesboro Site | |
|
117 S 11th Ave Laurel MS 39440-4312 | |
| (601) 425-3033 | |
| (601) 422-0431 |
| Full Name | Fhc Waynesboro Site |
|---|---|
| Speciality | Clinic/Center |
| Location | 117 S 11th Ave, Laurel, Mississippi |
| Authorized Official Name and Position | Rashad N Ali (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6014253033 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fhc Waynesboro Site 713 Lomax Ave Waynesboro MS 39367-2556 Ph: (601) 425-3033 | Fhc Waynesboro Site 117 S 11th Ave Laurel MS 39440-4312 Ph: (601) 425-3033 |
| NPI Number | 1477919603 |
|---|---|
| Provider Enumeration Date | 01/04/2016 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 9638163348 |
|---|---|
| Medicare Enrollment ID | O20160302001415 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477919603 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (Mississippi) | Primary |
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