| Holmes County Family Medicine- Vaiden | |
|
201a Magnolia St Vaiden MS 39176-5644 | |
| (601) 496-5400 | |
| Not Available |
| Full Name | Holmes County Family Medicine- Vaiden |
|---|---|
| Speciality | Clinic/Center |
| Location | 201a Magnolia St, Vaiden, Mississippi |
| Authorized Official Name and Position | Jeffrey Grimsley (ASST. CFO) |
| Authorized Official Contact | 6019859181 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Holmes County Family Medicine- Vaiden 201a Magnolia St Vaiden MS 39176-5644 Ph: (662) 496-5400 | Holmes County Family Medicine- Vaiden 201a Magnolia St Vaiden MS 39176-5644 Ph: (601) 496-5400 |
| NPI Number | 1841727971 |
|---|---|
| Provider Enumeration Date | 05/19/2017 |
| Last Update Date | 05/19/2017 |
| Medicare PECOS PAC ID | 1850293036 |
|---|---|
| Medicare Enrollment ID | O20170707000292 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841727971 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Dr Arenia C Mallory Community Health Center, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 201a Magnolia St, Vaiden, MS 39176 Phone: 662-464-5470 Fax: 662-464-0152 |