| Fmch Gloster Clinic | |
|
434 N Captain Gloster Dr Gloster MS 39638-3401 | |
| (601) 225-4711 | |
| (601) 225-7861 |
| Full Name | Fmch Gloster Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 434 N Captain Gloster Dr, Gloster, Mississippi |
| Authorized Official Name and Position | Bernard Richard Williams (CEO) |
| Authorized Official Contact | 6018900500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fmch Gloster Clinic 434 N Captain Gloster Dr Gloster MS 39638-3401 Ph: (601) 225-4711 | Fmch Gloster Clinic 434 N Captain Gloster Dr Gloster MS 39638-3401 Ph: (601) 225-4711 |
| NPI Number | 1144274622 |
|---|---|
| Provider Enumeration Date | 05/20/2006 |
| Last Update Date | 05/21/2026 |
| Certification Date | 05/21/2026 |
| Medicare PECOS PAC ID | 0547248544 |
|---|---|
| Medicare Enrollment ID | O20071205000518 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144274622 | NPI | - | NPPES |
| 009016303 | Medicaid | MS | |
| 09016303 | Medicaid | MS | |
| 1445096 | Medicaid | LA | |
| C02788 | Other | CAHABA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Secondary |
| 207R00000X | Internal Medicine | () | Secondary |
| 261QR1300X | Clinic/center - Rural Health | () | Primary |
| 363L00000X | Nurse Practitioner | () | Secondary |
Rkm Primary Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6002 Hancock Rd, Gloster, MS 39638 Phone: 601-225-7206 |
Gloster Dental Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 253 East Main Street, Gloster, MS 39638 Phone: 601-225-4119 Fax: 601-225-4620 |