| East Mississippi Community College | |
| 
					1512 Kemper St Scooba MS 39358-7601  | |
| (972) 367-4845 | |
| Not Available | 
| Full Name | East Mississippi Community College | 
|---|---|
| Speciality | General Practice | 
| Location | 1512 Kemper St, Scooba, Mississippi | 
| Authorized Official Name and Position | Mouzon Bass (ADMINISTRATOR/AGENT) | 
| Authorized Official Contact | 9723674845 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| East Mississippi Community College 5050 Spring Valley Rd Dallas TX 75244-3995 Ph: () -  | East Mississippi Community College 1512 Kemper St Scooba MS 39358-7601 Ph: (972) 367-4845  | 
| NPI Number | 1043780836 | 
|---|---|
| Provider Enumeration Date | 12/05/2018 | 
| Last Update Date | 12/05/2018 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1043780836 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary | 
Greater Meridian Health Clinic, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 927 Kemper St, Scooba, MS 39358 Phone: 662-476-9595 Fax: 844-778-8922  |