Organization
GREENE AREA MEDICAL EXTENDERS, INC
Active
Other names
Friends of Children State Line
Organization subpart
No
Provider details
NPI number
Authorized official
JOE DAWSEY (EXECUTIVE DIRECTOR)
(601) 394-2381
Entity
Organization
Contact information
Practice address
82 CHURCH STREET, STATE LINE, MS 39451
(601) 848-7650
Mailing address
P O BOX 160, LEAKESVILLE, MS 39451-0160
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
MS
Other
Enumeration date
05/18/2009
Last updated
05/18/2009
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