Healthcare Provider Details

I. General information

NPI: 1033903547
Provider Name (Legal Business Name): SOUTH CENTRAL CLINICS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2025
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 JEFFERSON ST
LAUREL MS
39440-4244
US

IV. Provider business mailing address

PO BOX 247
LAUREL MS
39441-0247
US

V. Phone/Fax

Practice location:
  • Phone: 601-426-3421
  • Fax: 601-426-2493
Mailing address:
  • Phone: 601-425-7550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BRITTANY RATCLIFF
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 601-399-6169