Organization
VOICE OF CALVARY FAMILY HEALTH CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRIMAUS WHEELER (CHIEF EXECUTIVE OFFICER)
(601) 984-8467
Entity
Organization
Contact information
Practice address
350 W WOODROW WILSON AVE, SUITE 611, JACKSON, MS 39213-7681
(601) 713-3233
(601) 713-2851
Mailing address
350 W WOODROW WILSON AVE, SUITE 615, JACKSON, MS 39213-7681
(601) 982-0673
(601) 713-2851
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
18106
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08753398
—
MS
01
—
25-1964
FQHC CMS CCN
MS
Enumeration date
06/12/2006
Last updated
05/15/2008
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