Provider Demographics
NPI:1730299827
Name:ACCESS FAMILY HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:ACCESS FAMILY HEALTH SERVICES, INC.
Other - Org Name:ACCESS FAMILY HEALTH - TREMONT 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 122
Mailing Address - Street 2:
Mailing Address - City:TREMONT
Mailing Address - State:MS
Mailing Address - Zip Code:38876-0122
Mailing Address - Country:US
Mailing Address - Phone:662-652-3361
Mailing Address - Fax:662-652-3363
Practice Address - Street 1:12725 HIGHWAY 23 NORTH
Practice Address - Street 2:
Practice Address - City:TREMONT
Practice Address - State:MS
Practice Address - Zip Code:38876
Practice Address - Country:US
Practice Address - Phone:662-652-3361
Practice Address - Fax:662-652-3363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2011-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
DB3359OtherRAILROAD MEDICARE PTAN
MS09014673Medicaid
DB3359OtherRAILROAD MEDICARE PTAN
MSC02928Medicare Oscar/Certification