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General NPI Number Information
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NPI Number | 1083767271
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Entity Type | Organization
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Legal Business Name | ABERDEEN HEALTH CLINIC INC
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 10/21/2019
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Provider Practice Location Address
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Address Line | 501 CHESTNUT STREET
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City | ABERDEEN
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State | MS
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Zip | 39730
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Country | US
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Telephone | 662-369-6131
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Fax | 662-369-4588
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Provider Business Mailing Address
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Address Line | PO BOX 892 501 CHESTNUT STREET
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City | ABERDEEN
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State | MS
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Zip | 39730
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Country | US
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Telephone | 662-369-6131
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Fax | 662-369-4588
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Authorized Official
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Title or Position | OWNER MANAGER
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Name | MS. EUNICE CRUMP
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Credential |
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Telephone | 662-369-6131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 8243
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | R857916
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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