Provider Demographics
NPI:1457461527
Name:ACCESS FAMILY HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:ACCESS FAMILY HEALTH SERVICES, INC.
Other - Org Name:ACCESS FAMILY HEALTH - HOULKA 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 187
Mailing Address - Street 2:
Mailing Address - City:HOULKA
Mailing Address - State:MS
Mailing Address - Zip Code:38850-0187
Mailing Address - Country:US
Mailing Address - Phone:662-568-3316
Mailing Address - Fax:662-568-3360
Practice Address - Street 1:106 WALKER ST
Practice Address - Street 2:
Practice Address - City:HOULKA
Practice Address - State:MS
Practice Address - Zip Code:38850
Practice Address - Country:US
Practice Address - Phone:662-568-3316
Practice Address - Fax:662-568-3360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS09014672Medicaid
DB3359OtherRAILROAD MEDICARE PTAN
251818Medicare Oscar/Certification
MSC02928Medicare Oscar/Certification