| Coastal Family Health Center, Inc | |
| 
					175 Annex Rd Leakesville MS 39451-9602  | |
| (601) 394-5093 | |
| (601) 394-6061 | 
| Full Name | Coastal Family Health Center, Inc | 
|---|---|
| Speciality | Clinic/Center | 
| Location | 175 Annex Rd, Leakesville, Mississippi | 
| Authorized Official Name and Position | Angelique Greer (CEO) | 
| Authorized Official Contact | 2283742494 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Coastal Family Health Center, Inc 10467 Corporate Dr Gulfport MS 39503-4634 Ph: (228) 374-2494  | Coastal Family Health Center, Inc 175 Annex Rd Leakesville MS 39451-9602 Ph: (601) 394-5093  | 
| NPI Number | 1700979960 | 
|---|---|
| Provider Enumeration Date | 10/02/2006 | 
| Last Update Date | 08/16/2024 | 
| Medicare PECOS PAC ID | 8628989654 | 
|---|---|
| Medicare Enrollment ID | O20170801000579 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1700979960 | NPI | - | NPPES | 
| 01429351 | Medicaid | MS | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary | 
Coastal Family Health Center Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4336 High School Rd, Leakesville, MS 39451 Phone: 601-394-6830 Fax: 601-394-6831  | |
Coastal Family Health Center Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 620 Main Street, Leakesville, MS 39451 Phone: 601-394-4507 Fax: 601-394-5615  | |
Greene County Clinic Hospital Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1017 Jackson Ave, Leakesville, MS 39451 Phone: 601-947-8181 Fax: 601-947-4411  | |
Greene County Family Medical Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1017 Jackson Ave, Leakesville, MS 39451 Phone: 601-394-2820 Fax: 601-394-2827  | |
Coastal Family Health Center Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 951 Main St, Leakesville, MS 39451 Phone: 601-394-2381 Fax: 601-394-2593  | |
Greene Rural Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1017 Jackson Ave, Leakesville, MS 39451 Phone: 601-394-4135 Fax: 601-394-4455  |