| Family Health Care Clinic, Inc. | |
|
150 J E Johnson Rd Prentiss MS 39474-3101 | |
| (601) 825-7280 | |
| (601) 825-8130 |
| Full Name | Family Health Care Clinic, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 150 J E Johnson Rd, Prentiss, Mississippi |
| Authorized Official Name and Position | Karina Marie Clayton (CHIEF FINANCIAL OFFICER) |
| 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. 150 J E Johnson Rd Prentiss MS 39474-3101 Ph: (601) 825-7280 |
| NPI Number | 1639644826 |
|---|---|
| Provider Enumeration Date | 10/04/2018 |
| Last Update Date | 10/04/2018 |
| Medicare PECOS PAC ID | 5395656946 |
|---|---|
| Medicare Enrollment ID | O20200820003173 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639644826 | NPI | - | NPPES |
| NONE | Other | MS | NONE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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