Quad Intermed Company Llc | |
106 Lake Vista Pl Brandon MS 39047-6384 | |
(601) 919-2924 | |
Not Available |
Full Name | Quad Intermed Company Llc |
---|---|
Speciality | Clinic/center |
Location | 106 Lake Vista Pl, Brandon, Mississippi |
Authorized Official Name and Position | William M Grantham (CEO) |
Authorized Official Contact | 6018987530 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Quad Intermed Company Llc 308 Corporate Dr Ridgeland MS 39157-8803 Ph: (601) 898-7530 | Quad Intermed Company Llc 106 Lake Vista Pl Brandon MS 39047-6384 Ph: (601) 919-2924 |
NPI Number | 1891578068 |
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Provider Enumeration Date | 08/14/2023 |
Last Update Date | 08/14/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1891578068 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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