| Southeast Mississippi Rural Health Initiative, Inc. | |
|
1411 Bradley Ave Beaumont MS 39423-0000 | |
| (601) 784-3922 | |
| (601) 784-3755 |
| Full Name | Southeast Mississippi Rural Health Initiative, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1411 Bradley Ave, Beaumont, Mississippi |
| Authorized Official Name and Position | Kaye Ray (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6015458700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Mississippi Rural Health Initiative, Inc. Po Box 235 Beaumont MS 39423-0235 Ph: (601) 784-3922 | Southeast Mississippi Rural Health Initiative, Inc. 1411 Bradley Ave Beaumont MS 39423-0000 Ph: (601) 784-3922 |
| NPI Number | 1831166826 |
|---|---|
| Provider Enumeration Date | 03/08/2006 |
| Last Update Date | 09/06/2022 |
| Medicare PECOS PAC ID | 2466342605 |
|---|---|
| Medicare Enrollment ID | O20091027000756 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831166826 | NPI | - | NPPES |
| 09015881 | Medicaid | MS | |
| 2382405 | Other | MS | MS UNITED HEALTH CARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Mississippi) | Primary |
Southeast Mississippi Rural Health Initiative, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1300 Beaumont Brooklyn Rd, Beaumont, MS 39423 Phone: 601-545-8700 Fax: 601-582-5461 |