Grenada Lake Medical Center in Grenada - Rural Health
Grenada Lake Medical Center - NPI 1154506277
Grenada Lake Medical Center is a Rural Health in Grenada, Mississippi. Grenada Lake Medical Center practices all healthcare services and medical treatments related to Rural Health. The NPI Number for Grenada Lake Medical Center is 1154506277. The last update date is 2008-01-08.
Grenada Lake Medical Center's current location address is 965 Avent Dr Ste 105, Grenada, Mississippi. You can contact this provider via phone number 6622277575. The mailing address for Grenada Lake Medical Center is 965 Avent Dr Ste 105, Grenada, Mississippi. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Grenada Lake Medical Center |
|---|---|
| Address | 965 Avent Dr Ste 105, Grenada, Mississippi |
| Phone Number | 6622277575 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CEO |
|---|---|
| Authorized Official Name | Denton L Charles |
| Telephone Number | 6622277005 |
NPI Number Detail
| NPI Number | 1154506277 |
|---|---|
| Provider Enumeration Date | 2008-01-08 |
| Last Updated Date | 2008-01-08 |
Provider Mailing Address Detail
| Address | 965 Avent Dr Ste 105 |
|---|---|
| City | Grenada |
| State | Mississippi (MS) |
| Post Code | 389015045 |
| Phone Number | 6622277575 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Rural Health |
|---|---|
| Taxonomy | 261Qr1300X |
| Licence No | 11-245 |
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Definition: Provides primary care and preventive health services in rural medically underserved areas. |
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What is the unique identifier code issued to Grenada Lake Medical Center by the Centers for Medicare & Medicaid Services?
The Grenada Lake Medical Center has been assigned the NPI (National Provider Identifier) 1154506277. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Grenada Lake Medical Center's physical address?
The Grenada Lake Medical Center is physically located at 965 Avent Dr Ste 105, in the city of Grenada, MS, with the postal code 389015045.
What is Grenada Lake Medical Center's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Grenada Lake Medical Center is Rural Health, and the corresponding taxonomy classification code for this specialized field is 261Qr1300X.
On what date did the Grenada Lake Medical Center receive the assignment of its 1154506277 from the Centers for Medicare & Medicaid Services?
The Grenada Lake Medical Center was issued its 1154506277 by the Centers for Medicare & Medicaid Services on 2008-01-08.
As of what date were the details related to Grenada Lake Medical Center most recently updated or revised?
The information pertaining to Grenada Lake Medical Center, including its address, specialty, and other relevant details, was last updated or revised on 2008-01-08.
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