Provider Demographics
NPI:1457453730
Name:ACCESS FAMILY HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:ACCESS FAMILY HEALTH SERVICES, INC.
Other - Org Name:ACCESS FAMILY HEALTH - SMITHVILLE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:SUMERFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-651-4686
Mailing Address - Street 1:PO BOX 305
Mailing Address - Street 2:
Mailing Address - City:SMITHVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38870-0305
Mailing Address - Country:US
Mailing Address - Phone:662-651-4637
Mailing Address - Fax:662-651-4636
Practice Address - Street 1:60021 MONROE ST
Practice Address - Street 2:
Practice Address - City:SMITHVILLE
Practice Address - State:MS
Practice Address - Zip Code:38870-7779
Practice Address - Country:US
Practice Address - Phone:662-651-4637
Practice Address - Fax:662-651-4636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-05
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
DB3359OtherRAILROAD MEDICARE PTAN
MS09011581Medicaid
MSC02928Medicare Oscar/Certification
251821Medicare Oscar/Certification