Organization · Type 2 NPI

Grenada Adult Healthcare Clinic Pc.

Primary Care Clinic/Center · Grenada, MS

NPI number 1144478512 Active

Practice location

965 J K Avent Dr, Suite 106
Grenada, MS 38901-5045

Fax (662) 227-6452

Specialties and licenses

TaxonomyCodeLicense
Medical Specialty Clinic/Center 261QM2500X20373 (MS)
Primary Care Clinic/Center Primary 261QP2300X20373 (MS)

Primary Care Clinic/Center: Definition to come...

2 other providers at this address

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About NPI 1144478512

Grenada Adult Healthcare Clinic Pc.'s National Provider Identifier is 1144478512, issued on Aug 28, 2008. The primary taxonomy on file is Primary Care Clinic/Center (261QP2300X), and the practice location is in Grenada, MS. The record was last updated on Aug 29, 2008.