| Jchc School Based Clinic High School | |
|
Route 1 Box 266 Fayette MS 39069 | |
| (601) 786-3475 | |
| (601) 786-9980 |
| Full Name | Jchc School Based Clinic High School |
|---|---|
| Speciality | Clinic/Center |
| Location | Route 1 Box 266, Fayette, Mississippi |
| Authorized Official Name and Position | Shirley A. Ellis (CEO) |
| Authorized Official Contact | 6017863475 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jchc School Based Clinic High School Post Office Box 98 Fayette MS 39069-5515 Ph: (601) 786-3475 | Jchc School Based Clinic High School Route 1 Box 266 Fayette MS 39069 Ph: (601) 786-3475 |
| NPI Number | 1922271691 |
|---|---|
| Provider Enumeration Date | 04/02/2008 |
| Last Update Date | 12/15/2010 |
| Medicare PECOS PAC ID | 0345248100 |
|---|---|
| Medicare Enrollment ID | O20101203000759 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922271691 | NPI | - | NPPES |
| 09015636 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Anazia Medical Ii, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1264 Main Street, Suite A, Fayette, MS 39069 Phone: 601-786-0390 Fax: 601-786-0730 | |
Bounds Family Medical Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 870 Main St Ste A, Fayette, MS 39069 Phone: 601-809-0882 Fax: 601-809-0883 | |
Prime Health & Wellness Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 225 Community Dr, Fayette, MS 39069 Phone: 601-786-8655 Fax: 601-786-8656 | |
Emergency Room Physicians Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 870 Main Street, Fayette, MS 39069 Phone: 601-786-3401 Fax: 601-786-3400 | |
Healsafe Wound Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1770 Highway 33, Fayette, MS 39069 Phone: 601-431-6040 | |
Jefferson Comprehensive Health Center, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 468 Highway 33, Fayette, MS 39069 Phone: 601-786-3475 Fax: 601-786-9980 | |
Jefferson County Hospital Er Physician Claims Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 870 Main Street, Fayette, MS 39069 Phone: 601-786-3401 Fax: 601-786-3400 |