| Southeast Mississippi Rural Health Initiative, Inc. | |
|
1300 Beaumont Brooklyn Rd Beaumont MS 39423-2233 | |
| (601) 545-8700 | |
| (601) 582-5461 |
| Full Name | Southeast Mississippi Rural Health Initiative, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1300 Beaumont Brooklyn Rd, Beaumont, 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. 1300 Beaumont Brooklyn Rd Beaumont MS 39423-2233 Ph: (601) 545-8700 |
| NPI Number | 1003852203 |
|---|---|
| Provider Enumeration Date | 06/22/2006 |
| Last Update Date | 09/06/2022 |
| Medicare PECOS PAC ID | 2466342605 |
|---|---|
| Medicare Enrollment ID | O20050324001248 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003852203 | NPI | - | NPPES |
| 01873344 | 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: 1411 Bradley Ave, Beaumont, MS 39423 Phone: 601-784-3922 Fax: 601-784-3755 |