Full Name | |
---|---|
Speciality | Clinic/center - Rural Health |
Location | 400 Lamar Ave, Kilmichael, Mississippi |
Authorized Official Name and Position | Dawne Holmes (CFO) |
Authorized Official Contact | 6624597119 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 1410 Greenwood MS 38935-1410 Ph: (662) 262-4284 | 400 Lamar Ave Kilmichael MS 39747 Ph: (662) 262-4284 |
NPI Number | 1124088299 |
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Provider Enumeration Date | 03/24/2006 |
Last Update Date | 06/24/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1124088299 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |