Mediquik Clinic | |
1350 Sunset Drive, Ste B Grenada MS 38901 | |
(662) 229-0669 | |
(662) 227-9929 |
Full Name | Mediquik Clinic |
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Speciality | Family Medicine |
Location | 1350 Sunset Drive, Ste B, Grenada, Mississippi |
Authorized Official Name and Position | Heather M Lipe (MANAGER/OWNER) |
Authorized Official Contact | 6622290669 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Mediquik Clinic Po Box 1607 Grenada MS 38902-1607 Ph: (662) 229-0669 | Mediquik Clinic 1350 Sunset Drive, Ste B Grenada MS 38901 Ph: (662) 229-0669 |
NPI Number | 1902010218 |
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Provider Enumeration Date | 05/09/2007 |
Last Update Date | 10/23/2019 |
Medicare PECOS PAC ID | 5799113833 |
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Medicare Enrollment ID | O20200324000336 |
Identifier | Type | State | Issuer |
---|---|---|---|
1902010218 | NPI | - | NPPES |
1740240944 | Other | MS | ALIENE DOWNS |
1720057565 | Other | MS | CINDY DOTSON |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Agnes Pamela Upchurch |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1063644599 PECOS PAC ID: 2961830005 Enrollment ID: I20200324000563 |
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