| Jackson Hinds Comprehensive Health Center | |
|
129 White Oak St Utica MS 39175-8803 | |
| (601) 882-6021 | |
| (601) 885-2268 |
| Full Name | Jackson Hinds Comprehensive Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 129 White Oak St, Utica, Mississippi |
| Authorized Official Name and Position | Jasmin Chapman (CEO) |
| Authorized Official Contact | 6013625321 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jackson Hinds Comprehensive Health Center 3502 W Northside Dr Jackson MS 39213-4454 Ph: (601) 362-5321 | Jackson Hinds Comprehensive Health Center 129 White Oak St Utica MS 39175-8803 Ph: (601) 882-6021 |
| NPI Number | 1700813052 |
|---|---|
| Provider Enumeration Date | 06/26/2006 |
| Last Update Date | 05/11/2012 |
| Medicare PECOS PAC ID | 4183533235 |
|---|---|
| Medicare Enrollment ID | O20110201000031 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700813052 | NPI | - | NPPES |
| 09014681 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Jackson Hinds Comprehensive Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 260 Highway 18, Utica, MS 39175 Phone: 601-885-8765 Fax: 601-885-2083 |