| Southeast Mississippi Rural Health Initiative, Inc | |
|
8 Burborne St Brooklyn MS 39425-9732 | |
| (061) 545-8700 | |
| (601) 582-5461 |
| Full Name | Southeast Mississippi Rural Health Initiative, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 8 Burborne St, Brooklyn, 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 8 Burborne St Brooklyn MS 39425-9732 Ph: (061) 545-8700 |
| NPI Number | 1306881149 |
|---|---|
| Provider Enumeration Date | 06/17/2006 |
| Last Update Date | 09/06/2022 |
| Medicare PECOS PAC ID | 2466342605 |
|---|---|
| Medicare Enrollment ID | O20050311000499 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306881149 | NPI | - | NPPES |
| 01130518 | 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: 215 Old Highway 49 E, Brooklyn, MS 39425 Phone: 601-545-8700 Fax: 601-450-2493 | |
Southeast Mississippi Rural Health Initiative, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 44 Brooklyn Janice Rd, Brooklyn, MS 39425 Phone: 601-582-1188 Fax: 601-582-8844 |