| Sharp Famity Care Center | |
|
501 Eagle Day Ave Columbia MS 39429-3605 | |
| (601) 731-9108 | |
| (601) 731-9190 |
| Full Name | Sharp Famity Care Center |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 501 Eagle Day Ave, Columbia, Mississippi |
| Authorized Official Name and Position | Benjamin Pettus (CEO) |
| Authorized Official Contact | 6018764926 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sharp Famity Care Center Po Box 256 Columbia MS 39429-0256 Ph: (601) 731-9108 | Sharp Famity Care Center 501 Eagle Day Ave Columbia MS 39429-3605 Ph: (601) 731-9108 |
| NPI Number | 1144407420 |
|---|---|
| Provider Enumeration Date | 01/29/2008 |
| Last Update Date | 01/29/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144407420 | NPI | - | NPPES |
| 09015059 | Medicaid | MS | |
| 231869 | Other | MS | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
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