Organization
SOUTHERN HEALTH CORP OF HOUSTON, INC.
Active
Other names
Family Medical Clinic of Okolona
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHEILA BROCKMAN (CEO)
(662) 456-3700
Entity
Organization
Contact information
Practice address
518 WEST DR, OKOLONA, MS 38860-1624
(662) 447-6170
Mailing address
PO BOX 432, HOUSTON, MS 38851-0432
(662) 476-1716
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09014527
—
MS
01
—
253417
TRISPAN
MS
01
—
C02044
MEDICARE PART B GROUP
MS
Enumeration date
08/25/2006
Last updated
01/18/2024
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