Organization
GREENE COUNTY FAMILY MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHY FENDER (ADMINISTRATOR)
(601) 947-8181
Entity
Organization
Contact information
Practice address
1017 JACKSON AVE, LEAKESVILLE, MS 39451-9105
(601) 394-2820
(601) 394-2827
Mailing address
PO BOX 1007, LUCEDALE, MS 39452-1007
(601) 947-1332
(601) 947-1331
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
11343
MS
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00118573
—
MS
01
—
258544
MEDICARE TRSIPAN
MS
Enumeration date
08/27/2008
Last updated
12/05/2019
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up