Full Name | |
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Speciality | Clinic/Center |
Location | 14101 Hickory St., Oakland, Mississippi |
Authorized Official Name and Position | Joe Meurrier (CLINIC ADMINISTRATOR) |
Authorized Official Contact | 6624731411 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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14101 Hickory Street Oakland MS 38948 Ph: () - | 14101 Hickory St. Oakland MS 38948 Ph: (662) 473-1411 |
NPI Number | 1942547161 |
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Provider Enumeration Date | 01/08/2013 |
Last Update Date | 01/08/2013 |
Medicare PECOS PAC ID | 4486601648 |
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Medicare Enrollment ID | O20130517000045 |
Identifier | Type | State | Issuer |
---|---|---|---|
1942547161 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |