Grenada Primary Care Clinic | |
965 Avent Dr Ste 105 Grenada MS 38901-5045 | |
(662) 227-7575 | |
Not Available |
Full Name | Grenada Primary Care Clinic |
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Speciality | Clinic/center - Rural Health |
Location | 965 Avent Dr Ste 105, Grenada, Mississippi |
Authorized Official Name and Position | Charles L Denton (CEO) |
Authorized Official Contact | 6622277005 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Grenada Primary Care Clinic 965 Avent Dr Ste 105 Grenada MS 38901-5045 Ph: (662) 227-7575 | Grenada Primary Care Clinic 965 Avent Dr Ste 105 Grenada MS 38901-5045 Ph: (662) 227-7575 |
NPI Number | 1154506277 |
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Provider Enumeration Date | 01/08/2008 |
Last Update Date | 01/08/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1154506277 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | 11-245 (Mississippi) | Primary |
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