University Of Mississippi Medical Center-grenada Rural Health Clinic | |
965 Avent Dr Ste 107 Grenada MS 38901-5045 | |
(662) 227-7000 | |
Not Available |
Full Name | University Of Mississippi Medical Center-grenada Rural Health Clinic |
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Speciality | Clinic/Center |
Location | 965 Avent Dr Ste 107, Grenada, Mississippi |
Authorized Official Name and Position | Jeffrey Grimsley (ASST. CFO) |
Authorized Official Contact | 6019849818 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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University Of Mississippi Medical Center-grenada Rural Health Clinic 2500 North State Street Jackson MS 39216 Ph: (601) 815-6381 | University Of Mississippi Medical Center-grenada Rural Health Clinic 965 Avent Dr Ste 107 Grenada MS 38901-5045 Ph: (662) 227-7000 |
NPI Number | 1528495454 |
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Provider Enumeration Date | 10/10/2013 |
Last Update Date | 06/12/2017 |
Medicare PECOS PAC ID | 1850293036 |
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Medicare Enrollment ID | O20140122000322 |
Identifier | Type | State | Issuer |
---|---|---|---|
1528495454 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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