Organization
WEST BOLIVAR ELEMENTARY
Active
Other names
West Bolivar Well Child Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HENRY PHILLIPS (SUPERINTENDENT)
(662) 759-3525
Entity
Organization
Contact information
Practice address
1212 SOUTH MAIN STREET, ROSEDALE, MS 38769-0429
(662) 759-3823
(662) 759-0027
Mailing address
1212 SOUTH MAIN STREET, P.O. BOX 429, ROSEDALE, MS 38769-0429
(662) 759-3823
(662) 759-0027
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
R865655
MS
Other
Enumeration date
11/08/2006
Last updated
08/22/2020
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