Organization
AMITE COUNTY MEDICAL SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAM T. POOLE (EXECUTIVE DIRECTOR)
(601) 657-4326
Entity
Organization
Contact information
Practice address
102 WEST FREEDOM DRIVE, LIBERTY, MS 39645-0511
(601) 657-4326
(601) 657-8867
Mailing address
PO BOX 511, LIBERTY, MS 39645-0511
(601) 657-4326
(601) 657-8867
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09010048
—
MS
05
—
09013203
—
MS
05
—
09015383
—
MS
Enumeration date
04/03/2007
Last updated
03/31/2008
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