| Enterprise Family Medical Center | |
|
83a Old Mill Creek Rd Enterprise MS 39330-9649 | |
| (601) 704-1020 | |
| (601) 704-1021 |
| Full Name | Enterprise Family Medical Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 83a Old Mill Creek Rd, Enterprise, Mississippi |
| Authorized Official Name and Position | John Anderson (VP) |
| Authorized Official Contact | 6017035010 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Enterprise Family Medical Center 2124 14th St Meridian MS 39301-4040 Ph: (601) 703-3480 | Enterprise Family Medical Center 83a Old Mill Creek Rd Enterprise MS 39330-9649 Ph: (601) 704-1020 |
| NPI Number | 1356780423 |
|---|---|
| Provider Enumeration Date | 06/21/2013 |
| Last Update Date | 06/03/2014 |
| Medicare PECOS PAC ID | 4284548025 |
|---|---|
| Medicare Enrollment ID | O20130823000566 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356780423 | NPI | - | NPPES |
| 04276719 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Anderson Family Medical Center - Enterprise Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 83 Old Mill Creek Road, Enterprise, MS 39330 Phone: 601-703-3465 Fax: 601-703-3408 |