institution
Southeast Mississippi Rural Health Initiative, Inc.
Federally Qualified Health Center (FQHC) in Petal, Mississippi
NPI 1952724650

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 1952724650 and holds a License No. (Mississippi).

The current practice location address for Southeast Mississippi Rural Health Initiative, Inc. is 36 Panther Stadium Dr, Petal, MS and can be reached out via phone at 601-450-2144 and via fax at 601-450-2145.

Location: 36 Panther Stadium Dr, Petal, MS, 39403-1729
institution
Provider Profile Details
NPI Number
1952724650
Provider Name
Southeast Mississippi Rural Health Initiative, Inc.
Credential
Provider Entity Type
Organization
Address
36 Panther Stadium Dr, Petal, MS, 39403-1729
Phone Number
601-450-2144
Fax Number
601-450-2145
Provider Enumeration Date
01/31/2014
Last Update Date
03/09/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
251023 01 MS MS MEDICARE PTAN
02622599 05 MS
institution
Provider Business Practice Location Address Details
Address
36 Panther Stadium Dr
City
State
Zip
39465-3632
Phone Number
601-450-2144
Fax Number
601-450-2145
person
Provider Business Mailing Address Details
Address
36 Panther Stadium Dr
City
State
Zip
39465-3632
Phone Number
601-450-2144
Fax Number
601-450-2145
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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