Philadelphia Health Center | |
10330 Road 375 Philadelphia MS 39350-3249 | |
(601) 656-0226 | |
(601) 656-0226 |
Full Name | Philadelphia Health Center |
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Speciality | Clinic/Center |
Location | 10330 Road 375, Philadelphia, Mississippi |
Authorized Official Name and Position | Tammy L Mcphail (INS. DEPT./MIS) |
Authorized Official Contact | 6016257140 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Philadelphia Health Center Po Box 142 Sebastopol MS 39359 Ph: (601) 625-7140 | Philadelphia Health Center 10330 Road 375 Philadelphia MS 39350-3249 Ph: (601) 656-0226 |
NPI Number | 1679529028 |
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Provider Enumeration Date | 05/26/2006 |
Last Update Date | 01/24/2011 |
Medicare PECOS PAC ID | 0941103717 |
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Medicare Enrollment ID | O20101015000695 |
Identifier | Type | State | Issuer |
---|---|---|---|
1679529028 | NPI | - | NPPES |
C02184 | Medicaid | MS | |
09014178 | Medicaid | MS | |
DA1146 | Other | RAILROAD MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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