Mount Olive Attendance Center | |
301 South 4th Street Mount Olive MS 39119-0000 | |
(601) 545-8700 | |
(601) 450-2493 |
Full Name | Mount Olive Attendance Center |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 301 South 4th Street, Mount Olive, Mississippi |
Authorized Official Name and Position | Kaye Ray (CEO) |
Authorized Official Contact | 6015458700 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Mount Olive Attendance Center Po Box 1729 Hattiesburg MS 39403-1729 Ph: (601) 545-8700 | Mount Olive Attendance Center 301 South 4th Street Mount Olive MS 39119-0000 Ph: (601) 545-8700 |
NPI Number | 1457800146 |
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Provider Enumeration Date | 09/23/2016 |
Last Update Date | 09/06/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1457800146 | NPI | - | NPPES |
03687771 | Medicaid | MS | |
251051 | Other | MS MEDICARE PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |