Organization
ABERDEEN HEALTH CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. EUNICE CRUMP (OWNER MANAGER)
(662) 369-6131
Entity
Organization
Contact information
Practice address
501 CHESTNUT STREET, ABERDEEN, MS 39730
(662) 369-6131
(662) 369-4588
Mailing address
PO BOX 892, 501 CHESTNUT STREET, ABERDEEN, MS 39730
(662) 369-6131
(662) 369-4588
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
8243
MS
208D00000X
General Practice Physician
R857916
MS
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09014086
—
MS
01
—
C20194
MEDICARE PART B
MS
Enumeration date
01/19/2007
Last updated
10/21/2019
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