MEDICARE: EAST CENTRAL MISSISSIPPI HEALTH CARE, INC

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	261QF0400X	Federally Qualified Health Center (FQHC)

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	DA1146	OTHER		RAILROAD MEDICARE

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	:	1255387619
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EAST CENTRAL MISSISSIPPI HEALTH CARE, INC

Provider Business Mailing Address
First Line	:	PO BOX 142
Second Line	:
City	:	SEBASTOPOL
State	:	MS
Zip	:	39359
Country	:	US
Telephone Number	:	601-625-7140
Fax Number	:	601-625-7199

Provider Business Practice Location Address
First Line	:	199 RIMMER ST
Second Line	:
City	:	WALNUT GROVE
State	:	MS
Zip	:	39189
Country	:	US
Telephone Number	:	601-253-2733
Fax Number	:	601-253-2733

Authorized Official
Title or Position	:	CEO
Name	:	MRS. JILL BISHOP
Credential	:
Telephone Number	:	601-625-7140

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	04/24/2025

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Directions to “EAST CENTRAL MISSISSIPPI HEALTH CARE, INC ” Practice Location

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