| Forrest Agricultural High School | |
|
215 Old Highway 49 E Brooklyn MS 39425-9028 | |
| (601) 545-8700 | |
| (601) 450-2493 |
| Full Name | Forrest Agricultural High School |
|---|---|
| Speciality | Clinic/Center |
| Location | 215 Old Highway 49 E, Brooklyn, Mississippi |
| Authorized Official Name and Position | Kaye Ray (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 6015458700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Forrest Agricultural High School Po Box 1729 Hattiesburg MS 39403-1729 Ph: (601) 545-8700 | Forrest Agricultural High School 215 Old Highway 49 E Brooklyn MS 39425-9028 Ph: (601) 545-8700 |
| NPI Number | 1407363559 |
|---|---|
| Provider Enumeration Date | 01/10/2018 |
| Last Update Date | 09/06/2022 |
| Medicare PECOS PAC ID | 2466342605 |
|---|---|
| Medicare Enrollment ID | O20180202000524 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407363559 | NPI | - | NPPES |
| 251068 | Other | MS | GROUP MEDICARE PTAN |
| 01131760 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
South Forrest Attendance Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8 Burborne St, Brooklyn, MS 39425 Phone: 061-545-8700 Fax: 601-582-5461 | |
Brooklyn Family Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 44 Brooklyn Janice Rd, Brooklyn, MS 39425 Phone: 601-582-1188 Fax: 601-582-8844 |