Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 7255 Gary Rd, Byram, Mississippi |
Authorized Official Name and Position | Jasmin Chapman (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 6013645142 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
3502 W Northside Dr Jackson MS 39213-4454 Ph: (601) 362-5321 | 7255 Gary Rd Byram MS 39272-8947 Ph: (601) 894-8590 |
NPI Number | 1811425291 |
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Provider Enumeration Date | 05/30/2017 |
Last Update Date | 06/16/2018 |
Medicare PECOS PAC ID | 4183533235 |
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Medicare Enrollment ID | O20170818000752 |
Identifier | Type | State | Issuer |
---|---|---|---|
1811425291 | NPI | - | NPPES |
PENDING | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Mea Primary Care Plus, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7300 S Siwell Rd, Byram, MS 39272 Phone: 601-373-1234 Fax: 601-373-1397 | |
Nps On Call, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Southpointe Dr, Byram, MS 39272 Phone: 601-724-9252 |