Independent Healthcare Management Inc
Doing business as Lackey Pediatric Clinic
Rural health clinic in Forest, MS, Medicare certification number 258608.
Medicare certification
Provider of Services- CCN
- 258608
- Status
- Active
- Provider type
- Rural health clinic
- Control type
- 2B
- Participating since
- Sep 9, 2015
- Last certification
- Aug 19, 2022
- Address
- 1129 Highway 35 South, Suite 1
Forest, MS 39074
(601) 469-3320
NPI records for this facility (CCN to NPI Mapping) 1
-
dba Lackey Pediatric Clinic
- Rural Health Clinic/Center
- Forest, MS
- NPI 1154670719
Medicare enrollment
Sources for this page
- Provider of Services: the certification, provider type, beds and status.
- Medicare Care Compare: the star rating and every measure on this page, with the state and national rates CMS publishes beside them.
- NPPES NPI Registry: the NPI records connected to this certification.