FAMILY HEALTH CARE CLINIC, INC. (NPI# 1376776930) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376776930 |
| Entity Type | Organization |
| Organization Name | FAMILY HEALTH CARE CLINIC, INC. |
| Practice Address |
225 Saint Paul Road Tylertown MS 39667 |
| Mailing Address |
Po Box 24116 Jackson MS 39225-4116 |
| Practice Telephone | 6018257280 |
| Practice Fax Number | 6018258130 |
| Mailing Telephone | 6018257280 |
| Mailing Fax Number | 6018258130 |
| Enumeration Date | 2009-08-31 |
| Last Update Date | 2018-07-04 |
| Authorized Official Name | KARINA MARIE CLAYTON (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 6018257280 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
MS | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00683565 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639644826 | Family Health Care Clinic, Inc. | Clinic/Center | 150 J E Johnson Rd, Prentiss, MS 39474-3101 | 2018-10-04 |
| 1083087985 | Family Health Care Clinic, Inc. | Clinic/Center | 102 Blackmur Dr, Water Valley, MS 38965 | 2015-11-02 |
| 1437412996 | Family Health Care Clinic, Inc. | Clinic/Center | 5096 Highway 49, Piney Woods, MS 39148 | 2012-06-20 |
| 1588992333 | Family Health Care Clinic, Inc. | Clinic/Center | 16410 Highway 72, Rogersville, AL 35652 | 2009-12-04 |
| 1881827434 | Family Health Care Clinic, Inc. | Clinic/Center | 125 School Rd, Mize Attendance Center, Mize, MS 39116 | 2009-08-31 |
| 1487887022 | Family Health Care Clinic, Inc. | Clinic/Center | 130 Lexie Road, Tylertown, MS 39429 | 2009-08-31 |
| 1801029467 | Family Health Care Clinic, Inc. | Clinic/Center | 125 Carter Street, Calhoun City, MS 38916 | 2009-08-31 |
| 1952534505 | Family Health Care Clinic, Inc. | Clinic/Center | 592 Schoolhouse Rd, Pinola, MS 39149 | 2009-08-31 |
| 1720211386 | Family Health Care Clinic, Inc. | Clinic/Center | 1823 Highway 24 West, Woodville, MS 39669 | 2009-08-31 |
| 1962635516 | Family Health Care Clinic, Inc. | Clinic/Center | 431 Old Highway 13 S, Columbia, MS 39429 | 2009-08-31 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | FAMILY HEALTH CARE CLINIC, INC. | 4635 Highway 80 E, Pearl, MS 39208-4226 |
| Street Address |
225 SAINT PAUL ROAD |
| City | TYLERTOWN |
| State | MS |
| Zip Code | 39667 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891212221 | Lavarshia Newsome-pittman | Pharmacist | 3000 Plaza Drive, Tylertown, MS 39667 | 2017-08-25 |
| 1891171039 | Tanya Marie Holmes-morris | Home Health Aide | 42 West Mt. Olive Rd, Tylertown, MS 39667 | 2015-08-10 |
| 1427221290 | Family Health Care Clinic, Inc. | Clinic/Center | 113 Enoch St, Tylertown, MS 39667 | 2008-04-11 |
| 1275651879 | John C Barrett | Dentist | 75 Old Hwy 98 E, Tylertown, MS 39667 | 2007-03-26 |
| 1497895551 | L & L Hospice, Inc. | Hospice Care, Community Based | 423 A Beulah, Tylertown, MS 39667 | 2007-02-07 |
| 1114009610 | Ruthie L Lewis | Licensed Practical Nurse | 423a Beulah Avenue, Tylertown, MS 39667 | 2006-10-20 |
| 1245512417 | Walthall General Hospital | Internal Medicine | 100 Hospital Drive, Tylertown, MS 39667 | 2011-09-14 |
| 1255649604 | Walthall General Hospital | General Acute Care Hospital | 200 Hospital Dr, Tylertown, MS 39667 | 2010-09-20 |
| 1407499296 | Belinda May Ratcliff | Pharmacist | 201 Hospital Dr, Tylertown, MS 39667-2019 | 2019-10-23 |
| 1639720717 | Tylertown Pharmacy LLC | Pharmacy | 201 Hospital Dr, Tylertown, MS 39667-2019 | 2019-09-20 |
| Find all providers in zip 39667 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487887022 | Family Health Care Clinic, Inc. | Clinic/Center | 130 Lexie Road, Tylertown, MS 39429 | 2009-08-31 |
| 1427221290 | Family Health Care Clinic, Inc. | Clinic/Center | 113 Enoch St, Tylertown, MS 39667 | 2008-04-11 |
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|---|---|---|---|---|
| 1871193722 | Coastal Family Health Center, Inc | Clinic/Center | 12424 Highway 57, Vancleave, MS 39565-8608 | 2020-10-29 |
| 1992305445 | Coastal Family Health Center, Inc | Clinic/Center | 5500 Hurley Wade Rd, Moss Point, MS 39562-8548 | 2020-10-26 |
| 1841890399 | Coastal Family Health Center, Inc | Clinic/Center | 10700 Yellow Jacket Rd, Ocean Springs, MS 39564-8038 | 2020-10-26 |
| 1033755343 | Access Family Health Services, Inc. | Clinic/Center | 179 Mullen Ave, Nettleton, MS 38858-6033 | 2019-11-21 |
| 1285280180 | Delta Health Center, Inc | Clinic/Center | 506 Washington Avenue, Moorhead, MS 38761 | 2019-08-15 |
| 1265088421 | Delta Health Center, Inc | Clinic/Center | 400 South Blvd, Drew, MS 38737-3508 | 2019-08-14 |
| 1215583356 | Delta Health Center, Inc. | Clinic/Center | 302 College Ave, Indianola, MS 38751-2112 | 2019-08-14 |
| 1063068252 | Delta Health Center, Inc | Clinic/Center | 1101 Oak St, Inverness, MS 38753-8725 | 2019-08-13 |
| 1750937959 | Delta Health Center, Inc | Clinic/Center | 212 E Claiborne St, Sunflower, MS 38778-9640 | 2019-08-13 |
| 1750937108 | Delta Health Center, Inc | Clinic/Center | 410 L F Packer Dr, Ruleville, MS 38771-3604 | 2019-08-12 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.