Organization
VICKSBURG CLINIC LLC
Active
Parent organization
VICKSBURG CLINIC LLC
Other names
River Region Rural Health - SC
Organization subpart
Yes
Provider details
NPI number
Legal business name
VICKSBURG CLINIC LLC
Authorized official
KRISTY MUSIC (DIRECTOR PROVIDER ENROLLMENT)
(877) 892-9815
Entity
Organization
Contact information
Practice address
2200 HIGHWAY 61 N, VICKSBURG, MS 39183-8246
(601) 883-3300
(601) 883-3302
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(615) 778-8071
(615) 628-6877
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
MS
Other
Enumeration date
07/20/2009
Last updated
11/05/2024
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