Organization
VOICE OF CALVARY FAMILY HEALTH CENTER INC
Active
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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