Organization
G A CARMICHAEL FAMILY HEALTH CENTER
Active
Other names
Webster Elementary School
Organization subpart
No
Provider details
NPI number
Authorized official
PHYLLIS G COTTEN (FINANCE DIRECTOR)
(601) 859-5213
Entity
Organization
Contact information
Practice address
622 E FOURTH ST, YAZOO CITY, MS 39194-3715
(601) 859-5213
(601) 859-8771
Mailing address
PO BOX 588, CANTON, MS 39046-0588
(601) 859-5213
(601) 859-8771
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
APPLIED FOR
—
MS
Enumeration date
07/06/2012
Last updated
07/06/2012
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