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General NPI Number Information
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NPI Number | 1578744900
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Entity Type | Organization
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Legal Business Name | FAMILY HEALTH CENTER, INC
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Dates
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Enumeration Date | 11/14/2007
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Last Update Date | 11/16/2010
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Provider Practice Location Address
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Address Line | 203 BROAD STREET
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City | SANDERSVILLE
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State | MS
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Zip | 39477-0279
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Country | US
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Telephone | 601-428-9918
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Fax | 601-649-5575
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Provider Business Mailing Address
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Address Line | P.O. BOX 4361
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City | LAUREL
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State | MS
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Zip | 39441-4361
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Country | US
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Telephone | 601-425-3033
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Fax | 601-422-0431
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. RASHAD N. ALI
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Credential | MD, JD, FACOG
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Telephone | 601-425-3033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State | MS
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