| Picayune Family Health Center | |
|
1911 Read Rd Picayune MS 39466-2730 | |
| (601) 545-8700 | |
| (601) 582-5461 |
| Full Name | Picayune Family Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1911 Read Rd, Picayune, Mississippi |
| Authorized Official Name and Position | Kaye Ray (C.E.O.) |
| Authorized Official Contact | 6015458700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Picayune Family Health Center Po Box 1729 Hattiesburg MS 39403-1729 Ph: (601) 545-8700 | Picayune Family Health Center 1911 Read Rd Picayune MS 39466-2730 Ph: (601) 545-8700 |
| NPI Number | 1003013764 |
|---|---|
| Provider Enumeration Date | 06/27/2007 |
| Last Update Date | 09/06/2022 |
| Medicare PECOS PAC ID | 2466342605 |
|---|---|
| Medicare Enrollment ID | O20070717000745 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003013764 | NPI | - | NPPES |
| C02142 | Other | MS | CAHABA MEDICARE GR NUMBER |
| 07250059 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Mississippi) | Primary |
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