Petal Primary School | |
60 Herrington Rd Petal MS 39465-8842 | |
(601) 545-8700 | |
(601) 450-2493 |
Full Name | Petal Primary School |
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Speciality | Clinic/Center |
Location | 60 Herrington Rd, Petal, Mississippi |
Authorized Official Name and Position | Geroldean Dyse (CEO) |
Authorized Official Contact | 6015458700 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Petal Primary School Po Box 1729 Hattiesburg MS 39403-1729 Ph: (601) 545-8700 | Petal Primary School 60 Herrington Rd Petal MS 39465-8842 Ph: (601) 545-8700 |
NPI Number | 1184961153 |
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Provider Enumeration Date | 01/11/2013 |
Last Update Date | 04/16/2021 |
Medicare PECOS PAC ID | 2466342605 |
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Medicare Enrollment ID | O20130201000379 |
Identifier | Type | State | Issuer |
---|---|---|---|
1184961153 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Mississippi) | Primary |
Petal High School Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1145 Highway 42, Petal, MS 39465 Phone: 601-545-8700 Fax: 601-450-2493 | |
Central Family Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 126 W Central Ave, Petal, MS 39465 Phone: 601-296-2552 Fax: 601-296-2397 | |
Morrison Medical Specialties Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 102 Red Maple Trl, Petal, MS 39465 Phone: 601-606-2554 | |
Runnelstown School Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 9214 Highway 42, Petal, MS 39465 Phone: 601-545-8700 Fax: 601-582-5461 | |
Immediate Care- Petal Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 50 Parkway Ln, Petal, MS 39465 Phone: 601-705-2897 Fax: 601-584-6457 | |
Runnelstown Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 15 Pumping Station Rd, Petal, MS 39465 Phone: 601-583-1559 Fax: 601-583-1573 |