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
| Taxonomy | Code | License |
|---|---|---|
| Medical Specialty Clinic/Center | 261QM2500X | 20373 (MS) |
| Primary Care Clinic/Center Primary | 261QP2300X | 20373 (MS) |
Primary Care Clinic/Center: Definition to come...
2 other providers at this address
Other primary care clinic/center providers in Grenada
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.