Garrett Healthcare Llc | |
762 Highway 468 Brandon MS 39042-9058 | |
(601) 824-0988 | |
(601) 824-0987 |
Full Name | Garrett Healthcare Llc |
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Speciality | Family Medicine |
Location | 762 Highway 468, Brandon, Mississippi |
Authorized Official Name and Position | Donald Garrett (OWNER) |
Authorized Official Contact | 6015023574 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Garrett Healthcare Llc 762 Highway 468 Brandon MS 39042-9058 Ph: (601) 824-0988 | Garrett Healthcare Llc 762 Highway 468 Brandon MS 39042-9058 Ph: (601) 824-0988 |
NPI Number | 1730736513 |
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Provider Enumeration Date | 08/26/2019 |
Last Update Date | 04/04/2024 |
Medicare PECOS PAC ID | 4284067976 |
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Medicare Enrollment ID | O20191211001186 |
Identifier | Type | State | Issuer |
---|---|---|---|
1730736513 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | James D Polk |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1083601348 PECOS PAC ID: 4486780483 Enrollment ID: I20100330000021 |
Provider Name | Donald J Garrett |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1023357274 PECOS PAC ID: 0446552780 Enrollment ID: I20160105000104 |
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