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NPI Code Detail

MEDICARE: GREATER MERIDIAN HEALTH CLINIC, INC

MEDICARE: GREATER MERIDIAN HEALTH CLINIC, 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
1261QF0400XFederally Qualified Health Center (FQHC)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1C00916OTHERALCAHABA
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1659472488
Entity Type Code : Organization
Provider Name (Legal Business Name) : GREATER MERIDIAN HEALTH CLINIC, INC
Provider Business Mailing Address
First Line : 2701 DAVIS ST
Second Line :
City : MERIDIAN
State : MS
Zip : 39301-5708
Country : US
Telephone Number : 601-693-0118
Fax Number : 601-693-2988
Provider Business Practice Location Address
First Line : 2701 DAVIS ST
Second Line :
City : MERIDIAN
State : MS
Zip : 39301-5708
Country : US
Telephone Number : 601-693-0118
Fax Number : 844-778-8922
Authorized Official
Title or Position : CEO
Name : WILBERT JONES
Credential :
Telephone Number : 601-693-0118
Provider Enumeration Date : 09/26/2006
Last Update Date : 05/03/2024

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Directions to “GREATER MERIDIAN HEALTH CLINIC, INC ” Practice Location

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