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NPI 1831198373

NPI 1831198373 : JONESTOWN HEALTH CENTER : JONESTOWN, MS

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General NPI Number Information
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    NPI Number           |    1831198373
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    Entity Type          |    Organization 
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    Legal Business Name  |    JONESTOWN HEALTH CENTER 
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Dates
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    Enumeration Date     |    07/18/2005
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    Last Update Date     |    08/22/2020
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Provider Practice Location Address
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    Address Line         |    280 SECOND STREET 
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    City                 |    JONESTOWN
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    State                |    MS
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    Zip                  |    38639-0079
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    Country              |    US
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    Telephone            |    662-358-4377
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    Fax                  |    662-358-4371
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Provider Business Mailing Address
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    Address Line         |    PO BOX 79 
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    City                 |    JONESTOWN
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    State                |    MS
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    Zip                  |    38639-0079
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    Country              |    US
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    Telephone            |    662-358-4377
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    Fax                  |    662-358-4371
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Authorized Official
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    Title or Position    |    COORDINATOR
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    Name                 |     GORETTI  GERMAIN 
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    Credential           |    
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    Telephone            |    662-358-4377
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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