COASTAL FAMILY HEALTH CENTER, INC (NPI# 1861950982) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861950982 |
| Entity Type | Organization |
| Organization Name | COASTAL FAMILY HEALTH CENTER, INC |
| Practice Address |
11231 Old 63 S Lucedale MS 39452-4941 |
| Mailing Address |
Po Box 475 Biloxi MS 39533-0475 |
| Practice Telephone | 2283742494 |
| Mailing Telephone | 2283742494 |
| Mailing Fax Number | 2283742713 |
| Enumeration Date | 2019-03-07 |
| Last Update Date | 2019-03-07 |
| Authorized Official Name | ANGELIQUE GREER (CEO) |
| Authorized Official Telephone | 2283742494 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| COASTAL FAMILY HEALTH CENTER, INC - LUCEDALE CLINIC | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1619465705 | Coastal Family Health Center, Inc | Clinic/Center | 4208 Jamestown Rd, Moss Point, MS 39563-9540 | 2018-04-25 |
| 1306343694 | Coastal Family Health Center, Inc | Clinic/Center | 6312 Martin Luther King Blvd, Moss Point, MS 39563-6126 | 2018-04-12 |
| 1538610118 | Coastal Family Health Center, Inc | Clinic/Center | 739 Division St, Biloxi, MS 39530-2210 | 2016-10-19 |
| 1548711120 | Coastal Family Health Center, Inc | Clinic/Center | 4630 Magnolia St, Moss Point, MS 39563-2659 | 2016-10-19 |
| 1528312519 | Coastal Family Health Center, Inc | Clinic/Center | 735 Division St, Biloxi, MS 39530-2213 | 2012-10-30 |
| 1700979960 | Coastal Family Health Center, Inc | Clinic/Center | 175 Annex Rd, Leakesville, MS 39451-9602 | 2006-10-02 |
| 1124016209 | Coastal Family Health Center, Inc | Clinic/Center | 109 Hospital Dr, Bay St Louis, MS 39520-1604 | 2005-10-12 |
| Street Address |
11231 OLD 63 S |
| City | LUCEDALE |
| State | MS |
| Zip Code | 39452-4941 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033420609 | Jennifer K. Walker | Massage Therapist | 352 Oak Street, Lucedale, MS 39452 | 2010-06-29 |
| 1780827543 | David J.conner D.d.s. | Dentist | 17215 Hwy 26, Lucedale, MS 39452 | 2009-04-09 |
| 1285873042 | Rebecca Graves | Nurse Practitioner | 92 W Ratliff St, Lucedale, MS 39452 | 2009-02-18 |
| 1639381791 | George County School District | Registered Nurse | Rocky Creek Elementary, 2183 Rocky Creek Road, Lucedale, MS 39452 | 2007-05-03 |
| 1386856425 | George County School District | Registered Nurse | Central Elementary School, 14159 Hwy 26 West, Lucedale, MS 39452 | 2007-05-03 |
| 1730301961 | George County School District | Registered Nurse | Agricola Elementary School, 6165 Hwy 613, Lucedale, MS 39452 | 2007-05-03 |
| 1932311156 | George County School District | Registered Nurse | Lucedale Elementary School, 689 Church Street, Lucedale, MS 39452 | 2007-05-03 |
| 1295947471 | George County School District | Registered Nurse | George County Middle School, 330 Church Street, Lucedale, MS 39452 | 2007-05-03 |
| 1952522583 | David J. Conner | Dentist | 17215 Highway 26 W, Lucedale, MS 39452 | 2007-05-01 |
| 1225258676 | Keith A Brown | Dentist | 16 Plaza Drive, Lucedale, MS 39452 | 2007-04-26 |
| Find all providers in zip 39452 | ||||
| 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 |
|---|---|---|---|---|
| 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 | ||||
Please comment or provide details below to improve the information on COASTAL FAMILY HEALTH CENTER, INC.
| 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.