Organization
SOUTHERN HEALTH CORP OF HOUSTON, INC.
Active
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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