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Organization

FAMILY HEALTH CARE CLINIC, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARGARET A GRAY DPA (PRESIDENT & CEO)
(601) 825-7280
Entity
Organization

Contact information

Practice address
100 BROOKS AVENUE, PELAHATCHIE, MS 39145
(601) 854-6805
(601) 854-6813
Mailing address
PO BOX 24116, JACKSON, MS 39225-4116
(601) 825-7280
(601) 825-8130

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
09014677
MS
Enumeration date
07/13/2006
Last updated
04/16/2020
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