| Amite County Medical Services, Inc. | |
|
102 West Freedom Drive Liberty MS 39645-0511 | |
| (601) 657-4326 | |
| (601) 657-8867 |
| Full Name | Amite County Medical Services, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 102 West Freedom Drive, Liberty, Mississippi |
| Authorized Official Name and Position | Pam T. Poole (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6016574326 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amite County Medical Services, Inc. Po Box 511 Liberty MS 39645-0511 Ph: (601) 657-4326 | Amite County Medical Services, Inc. 102 West Freedom Drive Liberty MS 39645-0511 Ph: (601) 657-4326 |
| NPI Number | 1073634226 |
|---|---|
| Provider Enumeration Date | 04/03/2007 |
| Last Update Date | 03/31/2008 |
| Medicare PECOS PAC ID | 5991607178 |
|---|---|
| Medicare Enrollment ID | O20040127000532 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073634226 | NPI | - | NPPES |
| 09013203 | Medicaid | MS | |
| 09015383 | Medicaid | MS | |
| 09010048 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Robert E Decoux |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487662763 PECOS PAC ID: 2365425113 Enrollment ID: I20080202000032 |
| Provider Name | Carla K Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013227743 PECOS PAC ID: 3072793116 Enrollment ID: I20110208000189 |
| Provider Name | Karen C Ross |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295097269 PECOS PAC ID: 3072761568 Enrollment ID: I20120906000598 |
| Provider Name | John M Douglas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730566175 PECOS PAC ID: 1557681756 Enrollment ID: I20150528002079 |
| Provider Name | Rasheeda C Hall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114280591 PECOS PAC ID: 0345483004 Enrollment ID: I20171005001983 |
| Provider Name | Melanie Robertson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427567791 PECOS PAC ID: 3678835287 Enrollment ID: I20180320000313 |
| Provider Name | Ndeke Nyirenda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326319088 PECOS PAC ID: 5799924098 Enrollment ID: I20180806001104 |
| Provider Name | Leonna Huhn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003322900 PECOS PAC ID: 4284998543 Enrollment ID: I20190508002636 |
| Provider Name | Catherine Newman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730786377 PECOS PAC ID: 1456762467 Enrollment ID: I20211005002859 |
| Provider Name | James L Westbrook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205500410 PECOS PAC ID: 1658769021 Enrollment ID: I20211104001078 |
| Provider Name | John C Carter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700348547 PECOS PAC ID: 0042682742 Enrollment ID: I20230206002662 |
| Provider Name | Carla A Webb |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457374159 PECOS PAC ID: 9739528159 Enrollment ID: I20240418002002 |
Amite County Medical Services, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 102 West Freedom Drive, Liberty, MS 39645 Phone: 601-657-1236 Fax: 601-657-9181 | |
Field Memorial Community Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1410 Main St. East, Liberty, MS 39645 Phone: 601-657-8820 |