| Family Health Care Clinic, Inc. | |
| 
					430 W Broad St Monticello MS 39654-7723  | |
| (601) 587-4492 | |
| (601) 587-7138 | 
| Full Name | Family Health Care Clinic, Inc. | 
|---|---|
| Speciality | Clinic/Center | 
| Location | 430 W Broad St, Monticello, Mississippi | 
| Authorized Official Name and Position | Margaret A Gray (PRESIDENT & CEO) | 
| Authorized Official Contact | 6018257280 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Family Health Care Clinic, Inc. Po Box 24116 Jackson MS 39225-4116 Ph: (601) 825-7280  | Family Health Care Clinic, Inc. 430 W Broad St Monticello MS 39654-7723 Ph: (601) 587-4492  | 
| NPI Number | 1093731234 | 
|---|---|
| Provider Enumeration Date | 07/14/2006 | 
| Last Update Date | 07/28/2022 | 
| Medicare PECOS PAC ID | 5395656946 | 
|---|---|
| Medicare Enrollment ID | O20080303000714 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1093731234 | NPI | - | NPPES | 
| 09014309 | Medicaid | MS | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Mississippi) | Primary | 
Bonita C. Musial Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 314 Main Street, Suite D, Monticello, MS 39654 Phone: 601-587-2785 Fax: 601-587-7799  | |
Southwest Mississippi Regional Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1167 E Broad St, Monticello, MS 39654 Phone: 601-587-1433 Fax: 601-587-1625  | |
Hattiesburg Clinic, Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 128 Courthouse Sq, Monticello, MS 39654 Phone: 601-587-0209 Fax: 601-587-0436  | |
James W Stephens Md Family Medicine Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 128 Courthouse Sq, Monticello, MS 39654 Phone: 601-587-0209 Fax: 601-587-0436  | |
Medical Clinic Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 713 Watts St, Monticello, MS 39654 Phone: 601-587-7795  | |
Southwest Mississippi Regional Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 827 F E Sellers Hwy, Monticello, MS 39654 Phone: 601-587-7405 Fax: 601-587-7407  |