| M. J. Edwards Center | |
|
643 W Service Dr Coldwater MS 38618-3822 | |
| (662) 624-4292 | |
| (662) 624-4354 |
| Full Name | M. J. Edwards Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 643 W Service Dr, Coldwater, Mississippi |
| Authorized Official Name and Position | Aurelia Jones-taylor (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 6626244292 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| M. J. Edwards Center 510 Highway 322 P O Box 1216 Clarksdale MS 38614-4717 Ph: (662) 624-2504 | M. J. Edwards Center 643 W Service Dr Coldwater MS 38618-3822 Ph: (662) 624-4292 |
| NPI Number | 1841616265 |
|---|---|
| Provider Enumeration Date | 03/10/2014 |
| Last Update Date | 06/04/2020 |
| Medicare PECOS PAC ID | 1153230560 |
|---|---|
| Medicare Enrollment ID | O20140924002279 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841616265 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Pravincha P. Patel, M.d. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 423 Central Ave, Coldwater, MS 38618 Phone: 662-622-7011 | |
Pravinchandra P. Patel, Md P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 423 Central Ave, Coldwater, MS 38618 Phone: 662-622-7011 Fax: 662-622-0257 |