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Organization

CLAIBORNE COUNTY FAMILY HEALTH CENTER, INC.

Active
Find providers by NPI
Organization

CLAIBORNE COUNTY FAMILY HEALTH CENTER, INC.

Active
Other names
P G Middle School School Base Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LADONNA DAVIS (CHIEF OPERATING OFFICER)
(601) 437-3050
Entity
Organization

Contact information

Practice address
161 RAMSEY DR, 2045 HIGHWAY 61 NORTH, PORT GIBSON, MS 39150-2531
(601) 437-9021
(601) 437-3051
Mailing address
2045 HIGHWAY 61 N, P O BOX 741, PORT GIBSON, MS 39150-4262
(601) 437-9021
(601) 437-3051

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03907367
MS
Enumeration date
07/24/2008
Last updated
12/19/2011
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