| Elite Care Family Medicine, Llc | |
|
571 Mitchell St Ste C Guntown MS 38849-8500 | |
| (662) 255-8324 | |
| (662) 348-2772 |
| Full Name | Elite Care Family Medicine, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 571 Mitchell St, Guntown, Mississippi |
| Authorized Official Name and Position | Kevin Miller (CO OWNER) |
| Authorized Official Contact | 6623483342 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Care Family Medicine, Llc 571 Mitchell St Ste C Guntown MS 38849-8500 Ph: (662) 348-3342 | Elite Care Family Medicine, Llc 571 Mitchell St Ste C Guntown MS 38849-8500 Ph: (662) 255-8324 |
| NPI Number | 1194128306 |
|---|---|
| Provider Enumeration Date | 10/01/2014 |
| Last Update Date | 04/19/2023 |
| Medicare PECOS PAC ID | 7214256601 |
|---|---|
| Medicare Enrollment ID | O20150506002292 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194128306 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 342 (Mississippi) | Primary |
| Provider Name | Lori Cleo Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811168578 PECOS PAC ID: 4082784327 Enrollment ID: I20080529000577 |
| Provider Name | Kevin S Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588097471 PECOS PAC ID: 2365670031 Enrollment ID: I20140103000010 |
| Provider Name | Hannah Reeves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932737202 PECOS PAC ID: 9830508076 Enrollment ID: I20210429001361 |
| Provider Name | Fulumirani Mccoy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598438483 PECOS PAC ID: 0143603340 Enrollment ID: I20220822001410 |
| Provider Name | Ashlyn Elena Stevens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306615398 PECOS PAC ID: 6204274764 Enrollment ID: I20240402004457 |