Organization
CLAIBORNE COUNTY FAMILY HEALTH CENTER
Active
Organization
CLAIBORNE COUNTY FAMILY HEALTH CENTER
Active
Other names
CCFHC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LADONNA BEASLEY DAVIS (CHIEF OPERATING OFFICER)
(601) 437-3052
Entity
Organization
Contact information
Practice address
2045 HIGHWAY 61 NORTH, PORT GIBSON, MS 39150-4262
(601) 437-3049
(601) 437-3051
Mailing address
2045 HIGHWAY 61 N, P O BOX 741, PORT GIBSON, MS 39150-4262
(601) 437-3049
(601) 437-3051
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
MS
261QP2300X
Primary Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09010054
—
MS
Enumeration date
06/10/2005
Last updated
09/24/2013
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