| Central Mississippi Civic Improvement Association, Inc | |
|
9700 I 20 Frontage Rd Bolton MS 39041-9126 | |
| (601) 866-2522 | |
| Not Available |
| Full Name | Central Mississippi Civic Improvement Association, Inc |
|---|---|
| Speciality | Clinic/center - Student Health |
| Location | 9700 I 20 Frontage Rd, Bolton, Mississippi |
| Authorized Official Name and Position | Jasmin Chapman (CEO) |
| Authorized Official Contact | 6013625321 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Central Mississippi Civic Improvement Association, Inc 3502 W. Northside Drive Jackson MS 39213-4454 Ph: (601) 362-5321 | Central Mississippi Civic Improvement Association, Inc 9700 I 20 Frontage Rd Bolton MS 39041-9126 Ph: (601) 866-2522 |
| NPI Number | 1760414494 |
|---|---|
| Provider Enumeration Date | 07/06/2006 |
| Last Update Date | 01/20/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760414494 | NPI | - | NPPES |
| 04224781 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QS1000X | Clinic/center - Student Health | (* (Not Available)) | Primary |
Health Wellness Promotion Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 115 W Madison St, Bolton, MS 39041 Phone: 601-866-7723 Fax: 601-866-7773 |