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CH043920 MANTACHIE RURAL HEALTH CARE INC (Active)
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Main Details
Name
MANTACHIE RURAL HEALTH CARE INC
Subdivision Name
Mantachie Rural Health Care, Inc.
Type
HRSA-Funded Health Center
Site ID
BPS-H80-008920
340B ID
CH043920
Grant Number
H80CS00096
Additional Details
Current Program Status
Active
Registration Date
10/1/1996
Participating Start Date
10/1/1996
Participating Approval Date
3/23/2004
Last Recertification Date
2/24/2025
Contacts
Authorizing Official
Mantachie Rural Health Care INc
james h jackson jr, CEO
(662) 282-4229
Primary Contact
Mantachie Rural Health Care Inc
Karen Burns, Office Manager
(662) 282-4229
Addresses
Street Address
5681 Highway 363
Mantachie, MS 38855-7632
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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2/28/12 - Changed main address from 5500 HIGHWAY 363 PO BOX 40. REPLACES FQHCLA043 AND COMBINES CHT38855
02/28/2012
REPLACES FQHCLA043 AND COMBINES CHT38855
05/01/2006
April 2025
April 2025
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