Organization
EAST CENTRAL MISSISSIPPI HEALTH CARE, INC
Active
Other names
Walnut Grove Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JILL BISHOP (CEO)
(601) 625-7140
Entity
Organization
Contact information
Practice address
199 RIMMER ST, WALNUT GROVE, MS 39189
(601) 253-2733
(601) 253-2733
Mailing address
PO BOX 142, SEBASTOPOL, MS 39359
(601) 625-7140
(601) 625-7199
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09013670
—
MS
01
—
DA1146
RAILROAD MEDICARE
—
Enumeration date
05/26/2006
Last updated
04/24/2025
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