| Ummc Grenda Specialty Peds | |
|
965 Avent Dr Ste 100b Grenada MS 38901-5045 | |
| (662) 227-7172 | |
| Not Available |
| Full Name | Ummc Grenda Specialty Peds |
|---|---|
| Speciality | Clinic/Center |
| Location | 965 Avent Dr Ste 100b, Grenada, Mississippi |
| Authorized Official Name and Position | Scott Whittemore (CFO GRENADA/HOLMES COUNTY) |
| Authorized Official Contact | 6622277172 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ummc Grenda Specialty Peds 965 Avent Dr Ste 100b Grenada MS 38901-5045 Ph: (662) 227-7172 | Ummc Grenda Specialty Peds 965 Avent Dr Ste 100b Grenada MS 38901-5045 Ph: (662) 227-7172 |
| NPI Number | 1578011417 |
|---|---|
| Provider Enumeration Date | 09/21/2016 |
| Last Update Date | 09/18/2018 |
| Medicare PECOS PAC ID | 1850293036 |
|---|---|
| Medicare Enrollment ID | O20170831002693 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578011417 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| 282NR1301X | General Acute Care Hospital - Rural | (* (Not Available)) | Secondary |
Woman's Health Clinic Of Grenada, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1401 Oak St, Grenada, MS 38901 Phone: 662-226-4010 Fax: 662-226-4495 | |
Grenada Specialty Clinic - Terry Pummer Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 965 Avent Dr Ste 100a, Grenada, MS 38901 Phone: 662-227-7444 Fax: 662-227-7443 | |
Grenada Primary Care Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 965 Avent Dr Ste 105, Grenada, MS 38901 Phone: 662-227-7575 | |
Grenada Primary Care Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 965 Avent Dr Ste 105, Grenada, MS 38901 Phone: 662-227-7575 | |
Grenada Diagnostic Radiology Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1300 Sunset Dr, Suite U, Grenada, MS 38901 Phone: 662-226-9279 Fax: 662-226-9779 | |
Grenada Lake Inpatient Medicine Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 960 J K Avent Dr, Grenada, MS 38901 Phone: 662-227-7492 Fax: 662-227-7541 | |
Mcgehee Family Health Clinic, P.a. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 100 E Monroe St, Grenada, MS 38901 Phone: 662-417-1710 |