| Central Mississippi Civic Improvement Association, Inc. | |
|
260 Highway 18 Utica MS 39175 | |
| (601) 885-8765 | |
| (601) 885-2083 |
| Full Name | Central Mississippi Civic Improvement Association, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 260 Highway 18, Utica, Mississippi |
| Authorized Official Name and Position | Jasmin Chapman (CEO) |
| Authorized Official Contact | 6013625321 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Central Mississippi Civic Improvement Association, Inc. 3502 W Northside Dr Jackson MS 39213-4454 Ph: (601) 362-5321 | Central Mississippi Civic Improvement Association, Inc. 260 Highway 18 Utica MS 39175 Ph: (601) 885-8765 |
| NPI Number | 1881628741 |
|---|---|
| Provider Enumeration Date | 07/10/2006 |
| Last Update Date | 07/09/2009 |
| Medicare PECOS PAC ID | 4183533235 |
|---|---|
| Medicare Enrollment ID | O20030331000006 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881628741 | NPI | - | NPPES |
| 02884328 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QS1000X | Clinic/center - Student Health | (* (Not Available)) | Primary |
Central Mississippi Civic Improvement Association, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 129 White Oak St, Utica, MS 39175 Phone: 601-882-6021 Fax: 601-885-2268 |