| Southeast Mississippi Rural Health Initiative, Inc. | |
| 
					598 W 11th Ave Lumberton MS 39455-2350  | |
| (601) 796-4215 | |
| (601) 796-9437 | 
| Full Name | Southeast Mississippi Rural Health Initiative, Inc. | 
|---|---|
| Speciality | Clinic/Center | 
| Location | 598 W 11th Ave, Lumberton, Mississippi | 
| Authorized Official Name and Position | Kaye Ray (EXECUTIVE DIRECTOR) | 
| Authorized Official Contact | 6015458700 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Southeast Mississippi Rural Health Initiative, Inc. P O Box 1729 Lumberton MS 39455-0000 Ph: (601) 796-4215  | Southeast Mississippi Rural Health Initiative, Inc. 598 W 11th Ave Lumberton MS 39455-2350 Ph: (601) 796-4215  | 
| NPI Number | 1164499174 | 
|---|---|
| Provider Enumeration Date | 03/08/2006 | 
| Last Update Date | 09/06/2022 | 
| Medicare PECOS PAC ID | 2466342605 | 
|---|---|
| Medicare Enrollment ID | O20091027000709 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1164499174 | NPI | - | NPPES | 
| 09014804 | Medicaid | MS | |
| 2704664 | Other | MS | MS UNITED HEALTH CARE | 
| C02142 | Other | MS | CAHABA MEDICARE GR NUMBER | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Mississippi) | Primary | 
Hattiesburg Clinic, Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 202 E Main Ave, Lumberton, MS 39455 Phone: 601-796-7030 Fax: 601-796-7956  | |
Southeast Mississippi Rural Health Initiative, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 7920 U S Highway 11, Lumberton, MS 39455 Phone: 601-796-2451 Fax: 601-796-9437  | |
Southeast Mississippi Rural Health Initiative, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7918 U S Highway 11, Lumberton, MS 39455 Phone: 601-796-2451 Fax: 601-450-0231  | |
Southeast Mississippi Rural Health Initiative, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 16 Ada Bounds Dr, Lumberton, MS 39455 Phone: 601-796-3721 Fax: 601-796-9437  | |
Southeast Mississippi Rural Health Initiative, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1201 Bilbo Rd, Lumberton, MS 39455 Phone: 601-796-4483 Fax: 601-796-9437  | |
Lumberton Public School District Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 107 E 10th Ave, Lumberton, MS 39455 Phone: 601-796-2441  |