Organization
COASTAL FAMILY HEALTH CENTER, INC.
Active
Other names
Coastal Family Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELIQUE S GREER (CEO)
(228) 374-2494
Entity
Organization
Contact information
Practice address
4770 AMOCO DR, MOSS POINT, MS 39563-9627
(228) 474-9511
(228) 474-9509
Mailing address
10467 CORPORATE DR, GULFPORT, MS 39503-4634
(228) 374-2494
(228) 374-0856
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04478868
—
MS
01
—
C00895
MEDICARE
MS
Enumeration date
08/04/2006
Last updated
08/16/2024
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