Provider Demographics
NPI:1083671895
Name:A & A HEALTH SYSTEMS, INC
Entity type:Organization
Organization Name:A & A HEALTH SYSTEMS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERYLL
Authorized Official - Middle Name:
Authorized Official - Last Name:FLETCHER-VINCENT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:601-981-3636
Mailing Address - Street 1:5440 WATKINS DR
Mailing Address - Street 2:STE A
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39206-2034
Mailing Address - Country:US
Mailing Address - Phone:601-981-3636
Mailing Address - Fax:601-982-5335
Practice Address - Street 1:5440 WATKINS DR
Practice Address - Street 2:STE A
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39206-2034
Practice Address - Country:US
Practice Address - Phone:601-981-3636
Practice Address - Fax:601-982-5335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-26
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00222826Medicaid
MS00222826Medicaid