| Southeast Mississippi Rural Health Initiative, Inc. | |
|
100 8th Ave S New Augusta MS 39462-0000 | |
| (601) 545-8700 | |
| (601) 582-5461 |
| Full Name | Southeast Mississippi Rural Health Initiative, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 100 8th Ave S, New Augusta, Mississippi |
| Authorized Official Name and Position | Kaye Ray (CEO) |
| 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. Po Box 1729 Hattiesburg MS 39403-1729 Ph: (601) 545-8700 | Southeast Mississippi Rural Health Initiative, Inc. 100 8th Ave S New Augusta MS 39462-0000 Ph: (601) 545-8700 |
| NPI Number | 1639115207 |
|---|---|
| Provider Enumeration Date | 06/21/2006 |
| Last Update Date | 09/06/2022 |
| Medicare PECOS PAC ID | 2466342605 |
|---|---|
| Medicare Enrollment ID | O20050324001252 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639115207 | NPI | - | NPPES |
| 09937036 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Mississippi) | Primary |
Southeast Mississippi Rural Health Initiative, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 9899 U S Hwy 98 E, New Augusta, MS 39462 Phone: 601-545-8700 Fax: 601-582-5461 | |
Southeast Mississippi Rural Health Initiative, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 404 Main Street, New Augusta, MS 39462 Phone: 601-964-8391 Fax: 601-964-8398 |