FRIENDS OF CHILDREN STATE LINE – NPI #1902031123
Clinic/Center

FRIENDS OF CHILDREN STATE LINE is an AHC clinic located in STATE LINE, MS. NPPES has assigned the NPI number 1902031123 to FRIENDS OF CHILDREN STATE LINE on May 18, 2009. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “FRIENDS OF CHILDREN STATE LINE” is a dba name, the actual legal business name for this organization is GREENE AREA MEDICAL EXTENDERS, INC. The primary taxonomy selected by this provider is 261QF0400X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Federally Qualified Health Center (FQHC)

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for FRIENDS OF CHILDREN STATE LINE below.

NPI Profile for
GREENE AREA MEDICAL EXTENDERS, INC

NPI Number
1902031123
Enumeration Date

(more than 17 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
GREENE AREA MEDICAL EXTENDERS, INC
Doing Business As (dba): FRIENDS OF CHILDREN STATE LINE
Primary location
82 CHURCH STREET
STATE LINE, MS 39451
Phone: (601) 848-7650 Fax:
Mailing address
P O BOX 160
LEAKESVILLE, MS 39451-0160
Phone: Fax:
Organization Subpart
No
Authorized Official
JOE DAWSEY
EXECUTIVE DIRECTOR
Phone: (601) 394-2381
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QF0400X
- Clinic/Center / Federally Qualified Health Center (FQHC) (Primary)		 MS

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.