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CH043060 NORTHEAST MISSISSIPPI HEALTH CARE, INC. (Active)
Main Details
Name
NORTHEAST MISSISSIPPI HEALTH CARE, INC.
Subdivision Name
DBA BYHALIA FAMILY HEALTH CENTER
Type
HRSA-Funded Health Center
Site ID
BPS-H80-002409
340B ID
CH043060
Grant Number
H80CS00432
Contacts
Authorizing Official
Northeast Mississippi Health Care, Inc.
Clifton Rodgers, Physician
(662) 349-6220
Primary Contact
Northeast Mississippi Health Care, Inc.
Andrea Chrestman, COO/CCO
(662) 838-2163 Ext: 235
Additional Details
Current Program Status
Active
Registration Date
12/1/1992
Participating Start Date
12/1/1992
Participating Approval Date
8/27/2004
Last Recertification Date
1/31/2024
Addresses
Street Address
12 BRUNSWICK ST
BYHALIA, MS 38611-0012
Billing Address
NORTHEAST MS HEALTH CARE, INC.
12 BRUNSWICK ST
PO BOX 698
BYHALIA, MS 38611
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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UPDATED CONTACT INFO
08/27/2004
May 2024
May 2024
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