MEDICARE: FAMILY CARE CLINIC, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center	901388	MS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124481791
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY CARE CLINIC, PLLC

Provider Business Mailing Address
First Line	:	PO BOX 3946
Second Line	:
City	:	GREENVILLE
State	:	MS
Zip	:	38704-3946
Country	:	US
Telephone Number	:	662-820-7780
Fax Number	:	888-980-6547

Provider Business Practice Location Address
First Line	:	1440 HIGHWAY 1 S
Second Line	:
City	:	GREENVILLE
State	:	MS
Zip	:	38701-7140
Country	:	US
Telephone Number	:	662-820-7780
Fax Number	:	888-980-6547

Authorized Official
Title or Position	:	OWNER/ADMINISTRATOR
Name	:	MRS. LAMONICA ANTONETTE HODGES
Credential	:	NP
Telephone Number	:	662-820-7780

Provider Enumeration Date	:	04/01/2016
Last Update Date	:	04/01/2016

Similar Medicare Providers

1700417961 — VANESSA HAYWOOD FNP
Practice Location Address:

1440 HIGHWAY 1 S
GREENVILLE, MS
38701-7140

Practice Phone: 662-235-9746
Practice Fax: 662-674-9156

1134056435 — QUALITY FAMILY MEDICAL CLINIC LLC
Practice Location Address:

1440 HIGHWAY 1 S
GREENVILLE, MS
38701-7140

Practice Phone: 662-721-6006
Practice Fax: 662-257-8833

1215957758 — RHONDA F POTTER NP
Practice Location Address:

1462 HIGHWAY 1 S
GREENVILLE, MS
38701-7140

Practice Phone: 662-702-5121
Practice Fax: 662-702-5123

1053550236 — DOMINICK TRINCA, M.D. PA
Practice Location Address:

1440 HIGHWAY 1 S
GREENVILLE, MS
38701-7140

Practice Phone: 662-820-4363
Practice Fax:

1992184022 — TRINCA PHARMACY PLLC
Practice Location Address:

1440 HIGHWAY 1 S
GREENVILLE, MS
38701-7140

Practice Phone: 662-820-4363
Practice Fax:

1437513108 — POTTER MEDICAL SERVICES LLC
Practice Location Address:

1462 HIGHWAY 1 S
GREENVILLE, MS
38701-7140

Practice Phone: 662-702-5121
Practice Fax: 662-702-5123

Directions to “FAMILY CARE CLINIC, PLLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.