MANTACHIE RURAL HEALTH CARE, INC. DENTAL (NPI# 1063779130) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063779130 |
| Entity Type | Organization |
| Organization Name | MANTACHIE RURAL HEALTH CARE, INC. DENTAL |
| Practice Address |
5500 Hwy 363 Mantachie MS 38855-7197 |
| Mailing Address |
5681 Hwy 363 Mantachie MS 38855-7197 |
| Practice Telephone | 6622824226 |
| Practice Fax Number | 6622827946 |
| Mailing Telephone | 6622824226 |
| Mailing Fax Number | 6622827946 |
| Enumeration Date | 2012-04-13 |
| Last Update Date | 2012-08-21 |
| Authorized Official Name | PATSY T. COLLINS (CEO) |
| Authorized Official Telephone | 6622824226 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Street Address |
5500 HWY 363 |
| City | MANTACHIE |
| State | MS |
| Zip Code | 38855-7197 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356997985 | Sonshine Pharmacy, LLC | Pharmacy | 2745 Highway 371 N, Mantachie, MS 38855 | 2019-08-09 |
| 1053885673 | Mantachie Rural Health Care, Inc | Clinic/Center | 311 Mustang Drive, Mantachie, MS 38855 | 2019-01-16 |
| 1992292536 | Mantachie Pharmacy LLC | Pharmacy | 3309 Highway 371 N, Mantachie, MS 38855 | 2018-04-19 |
| 1720589070 | Mantachie Rural Health Care Inc Behavioral Health | Clinic/Center | 5510 Hwy 363, Mantachie, MS 38855 | 2018-02-22 |
| 1962816447 | Travis Castleberry | Physical Therapist | 230a Main Street, Nettleton, MS 38855 | 2014-06-12 |
| 1891907093 | Community Family Healthcare, Inc | Nurse Practitioner | 285 Ivie Lane, Mantachie, MS 38855 | 2007-05-03 |
| 1750307328 | Freds Stores of Tennessee Inc | Durable Medical Equipment & Medical Supplies | 67 Watson Dr, Mantachie, MS 38855 | 2006-07-15 |
| 1497063085 | Jennifer Emily Bass | Specialist | 275 Morning View Lane, Mantachie, MS 38855-7096 | 2010-09-17 |
| 1780169557 | Andrea Carpenter | Nurse Practitioner | 3275 Highway 371 N, Mantachie, MS 38855-7145 | 2018-09-27 |
| 1164987426 | Hometown Care of Mantachie LLC | Nurse Practitioner | 3275 Highway 371 N, Mantachie, MS 38855-7145 | 2019-01-31 |
| Find all providers in zip 38855 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053885673 | Mantachie Rural Health Care, Inc | Clinic/Center | 311 Mustang Drive, Mantachie, MS 38855 | 2019-01-16 |
| 1720589070 | Mantachie Rural Health Care Inc Behavioral Health | Clinic/Center | 5510 Hwy 363, Mantachie, MS 38855 | 2018-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871193722 | Coastal Family Health Center, Inc | Clinic/Center | 12424 Highway 57, Vancleave, MS 39565-8608 | 2020-10-29 |
| 1992305445 | Coastal Family Health Center, Inc | Clinic/Center | 5500 Hurley Wade Rd, Moss Point, MS 39562-8548 | 2020-10-26 |
| 1841890399 | Coastal Family Health Center, Inc | Clinic/Center | 10700 Yellow Jacket Rd, Ocean Springs, MS 39564-8038 | 2020-10-26 |
| 1033755343 | Access Family Health Services, Inc. | Clinic/Center | 179 Mullen Ave, Nettleton, MS 38858-6033 | 2019-11-21 |
| 1285280180 | Delta Health Center, Inc | Clinic/Center | 506 Washington Avenue, Moorhead, MS 38761 | 2019-08-15 |
| 1265088421 | Delta Health Center, Inc | Clinic/Center | 400 South Blvd, Drew, MS 38737-3508 | 2019-08-14 |
| 1215583356 | Delta Health Center, Inc. | Clinic/Center | 302 College Ave, Indianola, MS 38751-2112 | 2019-08-14 |
| 1063068252 | Delta Health Center, Inc | Clinic/Center | 1101 Oak St, Inverness, MS 38753-8725 | 2019-08-13 |
| 1750937959 | Delta Health Center, Inc | Clinic/Center | 212 E Claiborne St, Sunflower, MS 38778-9640 | 2019-08-13 |
| 1750937108 | Delta Health Center, Inc | Clinic/Center | 410 L F Packer Dr, Ruleville, MS 38771-3604 | 2019-08-12 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.