FIRST CHOICE FAMILY HEALTHCARE CLINIC LLC NPI 1548720568

NPI Information

NPI: 1548720568
Provider Name: FIRST CHOICE FAMILY HEALTHCARE CLINIC LLC
Classification: Clinic/Center - 261QC1500X
Entity Type: Organization

Specialization: Community Health

CLIA Number: 25D2171128

Address:
119 S OAK STE 2
RAYMOND, MS
ZIP 39154
Phone: (601) 526-9001
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FIRST CHOICE FAMILY HEALTHCARE CLINIC LLC is a community health clinic center in Raymond, MS. FIRST CHOICE FAMILY HEALTHCARE CLINIC LLC NPI is 1548720568. The provider is registered as an organization entity type.

The provider's business location address is:

119 S OAK STE 2
RAYMOND, MS
ZIP 39154-205
Phone: (601) 526-9001
Fax: (601) 526-9118

The provider's authorized official is Morlyn Russell .
The authorized official title is Dnp/coo and has the following contact phone number (601) 526-9001.

The CLIA number assigned to this NPI record is 25D2171128 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/25/2019 and was last updated on 9/30/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QC1500X	Clinic/Center	Community Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1548720568	MEDICAID	MISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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