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342 Magnolia Dr Raleigh MS 39153-6012 | |
(601) 200-6809 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 342 Magnolia Dr, Raleigh, Mississippi |
Authorized Official Name and Position | John P. Lee (CHAIRMAN OF THE BOARD) |
Authorized Official Contact | 6014694151 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box D Forest MS 39074-0558 Ph: (601) 469-4151 | 342 Magnolia Dr Raleigh MS 39153-6012 Ph: (601) 200-6809 |
NPI Number | 1871272724 |
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Provider Enumeration Date | 07/17/2023 |
Last Update Date | 12/16/2024 |
Medicare PECOS PAC ID | 0840197232 |
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Medicare Enrollment ID | O20240819004069 |
Identifier | Type | State | Issuer |
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1871272724 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Family Health Care Clinic, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 226 Whiteoak Ave, Raleigh, MS 39153 Phone: 601-825-7280 Fax: 601-825-8130 |