institution
Southeast Mississippi Rural Health Initiative, Inc.
Federally Qualified Health Center (FQHC) in Petal, Mississippi
NPI 1821335894

Southeast Mississippi Rural Health Initiative, Inc. is a Federally Qualified Health Center (FQHC) based in Hattiesburg, MS and is specialized in Federally Qualified Health Center (FQHC). Southeast Mississippi Rural Health Initiative, Inc. practices in Petal, MS. The NPI Number for Southeast Mississippi Rural Health Initiative, Inc. is 1821335894 and holds a License No. (Mississippi).

The current practice location address for Southeast Mississippi Rural Health Initiative, Inc. is 400 Hillcrest Loop, Petal, MS and can be reached out via phone at 601-545-8700 and via fax at 601-450-2493.

Location: 400 Hillcrest Loop, Petal, MS, 39403-1729
institution
Provider Profile Details
NPI Number
1821335894
Provider Name
Southeast Mississippi Rural Health Initiative, Inc.
Credential
Provider Entity Type
Organization
Address
400 Hillcrest Loop, Petal, MS, 39403-1729
Phone Number
601-545-8700
Fax Number
601-450-2493
Provider Enumeration Date
01/11/2013
Last Update Date
03/09/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
251016 01 MS MS MEDICARE PTAN
06404731 05 MS
institution
Provider Business Practice Location Address Details
Address
400 Hillcrest Loop
City
State
Zip
39465-2634
Phone Number
601-545-8700
Fax Number
601-450-2493
person
Provider Business Mailing Address Details
Address
400 Hillcrest Loop
City
State
Zip
39465-2634
Phone Number
601-545-8700
Fax Number
601-450-2493
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Federally Qualified Health Center (FQHC)
Taxonomy
License No.
(Mississippi)
Definition
Definition to come...
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