Organization Name: | G A CARMICHAEL FAMILY HEALTH CENTER |
NPI Number: | 1184989196 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PHYLLIS G COTTEN (FINANCE DIRECTOR) |
Mailing Address: | 622 E Fourth St Yazoo City |
State: | MS US |
Postal Code: | 391943715 |
Phone Number: | 6018595213 |
Fax Number: | 6018598771 |
NPI Enumeration Date: | 07/06/2012 |
NPI Last Update Date: | 07/06/2012 |
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: |