Provider Demographics
NPI:1003096785
Name:FAMILY HEALTH CENTER, INC
Entity Type:Organization
Organization Name:FAMILY HEALTH CENTER, INC
Other - Org Name:OB / GYN CLINIC AT FAMILY HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RASHAD
Authorized Official - Middle Name:N
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD, JD
Authorized Official - Phone:601-425-3033
Mailing Address - Street 1:P.O. BOX 4361
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MS
Mailing Address - Zip Code:39441-4361
Mailing Address - Country:US
Mailing Address - Phone:601-425-3033
Mailing Address - Fax:601-422-0431
Practice Address - Street 1:103 S. 12TH AVENUE
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MS
Practice Address - Zip Code:39440
Practice Address - Country:US
Practice Address - Phone:601-399-1970
Practice Address - Fax:601-399-2832
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:N/A
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-09
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty