Organization
G.A. CARMICHAEL FAMILY HEALTH CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES L. COLEMAN JR. ED. D (CEO)
(601) 859-5213
Entity
Organization
Contact information
Practice address
10340 HIGHWAY 433 W, BENTONIA, MS 39040
(662) 755-2518
(601) 859-8771
Mailing address
10340 HIGHWAY 433 W, BENTONIA, MS 39040-9416
(601) 859-5213
(601) 859-8771
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09207040
—
MS
Enumeration date
11/07/2016
Last updated
06/25/2018
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