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11700 Highway 57 Vancleave MS 39565-8309 | |
(228) 826-1482 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 11700 Highway 57, Vancleave, Mississippi |
Authorized Official Name and Position | Lee Bond (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 2284977591 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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2101 Highway 90 Gautier MS 39553-5340 Ph: (228) 497-8874 | 11700 Highway 57 Vancleave MS 39565-8309 Ph: (228) 826-1482 |
NPI Number | 1255728838 |
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Provider Enumeration Date | 04/21/2015 |
Last Update Date | 04/21/2015 |
Medicare PECOS PAC ID | 3870405194 |
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Medicare Enrollment ID | O20150619001991 |
Identifier | Type | State | Issuer |
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1255728838 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Whole Family Care Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 10404 Tucker Rd, Vancleave, MS 39565 Phone: 228-354-9505 | |