Organization
SOUTHEAST MISSISSIPPI RURAL HEALTH INITIATIVE, INC.
Active
Organization
SOUTHEAST MISSISSIPPI RURAL HEALTH INITIATIVE, INC.
Active
Other names
Collins Elementary School
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KAYE RAY CEO (CHEIF EXECUTIVE OFFICER)
(601) 545-8700
Entity
Organization
Contact information
Practice address
401 DOGWOOD STREET, COLLINS, MS 39428-0000
(601) 765-4383
(601) 450-2493
Mailing address
PO BOX 1729, HATTIESBURG, MS 39403-1729
(601) 545-8700
(601) 450-2493
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09405885
—
MS
01
—
251048
MS MEDICARE PTAN
—
Enumeration date
09/07/2016
Last updated
09/02/2022
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