Organization Name: | AMITE COUNTY MEDICAL SERVICES, INC. |
NPI Number: | 1073634226 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PAM T. POOLE (EXECUTIVE DIRECTOR) |
Mailing Address: | 102 West Freedom Drive Liberty |
State: | MS US |
Postal Code: | 396450511 |
Phone Number: | 6016574326 |
Fax Number: | 6016578867 |
NPI Enumeration Date: | 04/03/2007 |
NPI Last Update Date: | 03/31/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QF0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
Taxonomy Definition: |