| Medical Mobile Unit | |
|
510 Highway 322 Clarksdale MS 38614-4717 | |
| (662) 624-4292 | |
| (662) 624-4354 |
| Full Name | Medical Mobile Unit |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 510 Highway 322, Clarksdale, Mississippi |
| Authorized Official Name and Position | Aurelia Taylor (CHEIF EXECUTIVE OFFICER) |
| Authorized Official Contact | 6626244292 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Mobile Unit 510 Highway 322 P O Box 1216 Clarksdale MS 38614-4717 Ph: (662) 624-4292 | Medical Mobile Unit 510 Highway 322 Clarksdale MS 38614-4717 Ph: (662) 624-4292 |
| NPI Number | 1366440331 |
|---|---|
| Provider Enumeration Date | 07/13/2005 |
| Last Update Date | 06/02/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366440331 | NPI | - | NPPES |
| 01085372 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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