Organization
FAMILY HEALTH CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CONEY LEE JOHNSON (CHIEF OPERATING OFFICER)
(601) 425-3033
Entity
Organization
Contact information
Practice address
5192 HIGHWAY 11 N, ELLISVILLE, MS 39437-5050
(601) 425-3033
(601) 428-6561
Mailing address
P O BOX 4361 117 SOUTH 11TH AVENUE, LAUREL, MS 39441
(601) 425-3033
(601) 428-6561
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
10/01/2019
Last updated
01/17/2020
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