| |
345 Highway 15 N Pontotoc MS 38863-1105 | |
(662) 489-7430 | |
Not Available |
Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 345 Highway 15 N, Pontotoc, Mississippi |
Authorized Official Name and Position | Bruce Toppin (CORPORATE SECRETARY) |
Authorized Official Contact | 6623774229 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
176 S Main St Pontotoc MS 38863-3311 Ph: (662) 488-7670 | 345 Highway 15 N Pontotoc MS 38863-1105 Ph: (662) 489-7430 |
NPI Number | 1538576772 |
---|---|
Provider Enumeration Date | 07/21/2014 |
Last Update Date | 01/20/2025 |
Medicare PECOS PAC ID | 6002895356 |
---|---|
Medicare Enrollment ID | O20141013000785 |
Identifier | Type | State | Issuer |
---|---|---|---|
1538576772 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | 16091 (Mississippi) | Primary |
Redmed, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12 Brookes Xing, Pontotoc, MS 38863 Phone: 662-489-4044 | |
Flavia H West Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 183 S Main St, Pontotoc, MS 38863 Phone: 662-489-5038 Fax: 662-489-7004 | |