Organization
PETAL UPPER ELEMENTARY SCHOOL
Active
Parent organization
SOUTHEAST MISSISSIPPI RURAL HEALTH INITIATIVE, INC.
Other names
Petal Upper Elementary School
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHEAST MISSISSIPPI RURAL HEALTH INITIATIVE, INC.
Authorized official
JANICE ROBINSON (CEO)
(601) 545-8700
Entity
Organization
Contact information
Practice address
400 HILLCREST LOOP, PETAL, MS 39465-2634
(601) 545-8700
(601) 450-2493
Mailing address
PO BOX 1729, HATTIESBURG, MS 39403-1729
(601) 545-3700
(601) 450-2493
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006404731
—
MS
05
—
06404731
—
MS
01
—
251016
MS MEDICARE PTAN
MS
Enumeration date
01/11/2013
Last updated
02/05/2026
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