| Indianola Wellness Clinic, Llc | |
| 
					131 Main St Indianola MS 38751-2849  | |
| (662) 303-3743 | |
| Not Available | 
| Full Name | Indianola Wellness Clinic, Llc | 
|---|---|
| Speciality | Clinic/center - Primary Care | 
| Location | 131 Main St, Indianola, Mississippi | 
| Authorized Official Name and Position | Kajuandra K Chandler (MANAGER/OWNER) | 
| Authorized Official Contact | 6623033743 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Indianola Wellness Clinic, Llc 108 Whittington Dr Indianola MS 38751-3434 Ph: (662) 303-3743  | Indianola Wellness Clinic, Llc 131 Main St Indianola MS 38751-2849 Ph: (662) 303-3743  | 
| NPI Number | 1508393000 | 
|---|---|
| Provider Enumeration Date | 05/15/2017 | 
| Last Update Date | 06/16/2018 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1508393000 | NPI | - | NPPES | 
| 03321871 | Medicaid | MS | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 901379 (Mississippi) | Primary | 
South Sunflower County Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 E Baker St, Suite A, Indianola, MS 38751 Phone: 662-887-7081 Fax: 662-887-3920  | |
Delta Health Center, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 302 College Ave, Indianola, MS 38751 Phone: 662-884-1260 Fax: 662-741-2700  | |
South Sunflower County Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 122 E Baker St, Indianola, MS 38751 Phone: 662-887-2212 Fax: 662-887-1279  | |
South Sunflower County Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 122 E Baker St, Indianola, MS 38751 Phone: 662-887-2212 Fax: 662-887-1279  | |
South Sunflower County Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 E Baker St, Indianola, MS 38751 Phone: 662-887-7339 Fax: 662-887-3920  | |
American Psych Associates, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 612 Sunflower Avenue Ext, Suite 14, Indianola, MS 38751 Phone: 601-720-7605 Fax: 866-495-3240  |