Organization
COASTAL FAMILY HEALTH CENTER, INC
Active
Other names
Coastal Family Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANGELIQUE S GREER (CEO)
(228) 374-2494
Entity
Organization
Contact information
Practice address
10828 HIGHWAY 57, VANCLEAVE, MS 39565-8264
(228) 826-4711
(228) 374-0856
Mailing address
10467 CORPORATE DR, GULFPORT, MS 39503-4634
(228) 374-2494
(228) 374-0856
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9011503
—
MS
01
—
C00895
MEDICARE
MS
Enumeration date
10/12/2005
Last updated
08/16/2024
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