| Holcomb Clinic | |
|
1301 Sunset Dr Ste E Grenada MS 38901-4103 | |
| (662) 229-9787 | |
| (662) 229-9770 |
| Full Name | Holcomb Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1301 Sunset Dr Ste E, Grenada, Mississippi |
| Authorized Official Name and Position | Tina Rene Vest (BILLING MANAGER) |
| Authorized Official Contact | 6626257111 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Holcomb Clinic Po Box 230 Charleston MS 38921-0240 Ph: (662) 647-5535 | Holcomb Clinic 1301 Sunset Dr Ste E Grenada MS 38901-4103 Ph: (662) 229-9787 |
| NPI Number | 1932591468 |
|---|---|
| Provider Enumeration Date | 02/20/2015 |
| Last Update Date | 06/21/2021 |
| Medicare PECOS PAC ID | 1052208097 |
|---|---|
| Medicare Enrollment ID | O20150421001630 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932591468 | NPI | - | NPPES |
| 05820575 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (Mississippi) | Primary |
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