| Family Health Care Clinic, Inc. | |
| 
					100 Brooks Avenue Pelahatchie MS 39145  | |
| (601) 854-6805 | |
| (601) 854-6813 | 
| Full Name | Family Health Care Clinic, Inc. | 
|---|---|
| Speciality | Clinic/Center | 
| Location | 100 Brooks Avenue, Pelahatchie, 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. 100 Brooks Avenue Pelahatchie MS 39145 Ph: (601) 854-6805  | 
| NPI Number | 1467478743 | 
|---|---|
| Provider Enumeration Date | 07/13/2006 | 
| Last Update Date | 04/16/2020 | 
| Medicare PECOS PAC ID | 5395656946 | 
|---|---|
| Medicare Enrollment ID | O20080303000387 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1467478743 | NPI | - | NPPES | 
| 09014677 | Medicaid | MS | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Mississippi) | Primary | 
Care Plus Pelahatchie Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 501 Highway 80 East, Pelahatchie, MS 39145 Phone: 601-854-8002 Fax: 601-854-7333  | |
Pelahatchie Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 507 Second St, Pelahatchie, MS 39145 Phone: 601-854-8002  |