| |
1800 12th St Meridian MS 39301-4158 | |
(601) 703-9265 | |
(601) 703-3224 |
Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 1800 12th St, Meridian, Mississippi |
Authorized Official Name and Position | Don Larkin Kennedy (REGIONAL CEO) |
Authorized Official Contact | 6017039614 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Dept 3027 P O Box 1000 Memphis TN 38148-3027 Ph: (601) 213-3010 | 1800 12th St Meridian MS 39301-4158 Ph: (601) 703-9265 |
NPI Number | 1275910663 |
---|---|
Provider Enumeration Date | 05/05/2015 |
Last Update Date | 04/26/2023 |
Medicare PECOS PAC ID | 2567368541 |
---|---|
Medicare Enrollment ID | O20150609000306 |
Identifier | Type | State | Issuer |
---|---|---|---|
1275910663 | NPI | - | NPPES |
009016210 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Greater Meridian Health Clinic, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2701 Davis St, Meridian, MS 39301 Phone: 601-693-0118 Fax: 844-778-8922 | |
Greater Meridian Health Clinic, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2701 Davis St, Meridian, MS 39301 Phone: 601-693-0118 Fax: 844-778-8922 | |
Primary Medical Services Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5000 Highway 39 N, Meridian, MS 39301 Phone: 601-646-0898 | |