Odom Rural Health Clinic | |
645 South Main Street Water Valley MS 38965 | |
(662) 473-1311 | |
Not Available |
Full Name | Odom Rural Health Clinic |
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Speciality | Clinic/Center |
Location | 645 South Main Street, Water Valley, Mississippi |
Authorized Official Name and Position | Terry L Varner (ADMINISTRATOR) |
Authorized Official Contact | 6624731411 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Odom Rural Health Clinic 645 Hwy 7 South Water Valley MS 38965-0645 Ph: (662) 473-1311 | Odom Rural Health Clinic 645 South Main Street Water Valley MS 38965 Ph: (662) 473-1311 |
NPI Number | 1356402002 |
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Provider Enumeration Date | 12/13/2006 |
Last Update Date | 12/10/2007 |
Medicare PECOS PAC ID | 4486601648 |
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Medicare Enrollment ID | O20070329000594 |
Identifier | Type | State | Issuer |
---|---|---|---|
1356402002 | NPI | - | NPPES |
09013597 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (Mississippi) | Primary |
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