Claiborne County Family Health Center, Inc.
Organization Active NPI Federally Qualified Health Center (FQHC) · Port Gibson, MS
NPI 1194968982 · NPPES record last updated Apr 9, 2009
Key facts
- NPI
- 1194968982
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- CLAIBORNE COUNTY FAMILY HEALTH CENTER, INC.
- Practice address
- 2045 Highway 61 N
Port Gibson, MS 39150-4262 - Phone
- (601) 437-3049
- Fax
- (601) 437-3051
- NPI assigned
- Apr 9, 2009
- Organization subpart
- No
Authorized official
- Name
- Coney L Johnson
- Title
- Chief Executive Officer
- Phone
- (601) 437-3052
Corporate family (same tax ID) 2
Practitioners 5
-
Keith D Bishop, DDS
-
Shaunda T Freeman, FNP
-
Arlene Hunt, FNP
-
Demetri W Marshall, M.D.
-
Marvell Spears, FNP
National Provider Directory
- Tax ID family
- Claiborne County Family Health Center Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Clinic/Center | 261QD0000X | MS | ||
| Federally Qualified Health Center (FQHC) | 261QF0400X | MS | Yes |
Addresses
Primary practice location
2045 Highway 61 N
Port Gibson, MS 39150-4262
Mailing address
PO Box 741
Port Gibson, MS 39150-0741
Phone (601) 437-3049
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09013386 | Medicaid | MS |
Other providers in Port Gibson, MS
- Angel Brinner
- Clare Nelson Burnett
- Kimberly Janell Carson
- Claib Cty HSP Pro Fees
- Claiborne County Family Health Center
- Claiborne County Family Health Center, Inc.
- Claiborne County Family Health Center, Inc.
- Claiborne County Hospital
- Claiborne County Hospital
- Claiborne County Hospital
All providers in Port Gibson, MS · Federally Qualified Health Center (FQHC) in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 9, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.