Grenada Lake Medical Center in Grenada - Skilled Nursing Facility
Grenada Lake Medical Center - NPI 1053386870
Grenada Lake Medical Center is a Skilled Nursing Facility in Grenada, Mississippi. Grenada Lake Medical Center practices all healthcare services and medical treatments related to Skilled Nursing Facility. The NPI Number for Grenada Lake Medical Center is 1053386870. The last update date is 2007-12-12.
Grenada Lake Medical Center's current location address is 960 Avent Dr, Grenada, Mississippi. You can contact this provider via phone number 6622277000 and fax number 6622277534. The mailing address for Grenada Lake Medical Center is 960 Avent Dr, Grenada, Mississippi. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Grenada Lake Medical Center |
|---|---|
| Address | 960 Avent Dr, Grenada, Mississippi |
| Phone Number | 6622277000 |
| Fax Number | 6622277534 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CEO |
|---|---|
| Authorized Official Name | Denton L Charles |
| Telephone Number | 6622277005 |
NPI Number Detail
| NPI Number | 1053386870 |
|---|---|
| Provider Enumeration Date | 2006-02-23 |
| Last Updated Date | 2007-12-12 |
Provider Mailing Address Detail
| Address | 960 Avent Dr |
|---|---|
| City | Grenada |
| State | Mississippi (MS) |
| Post Code | 389015230 |
| Phone Number | 6622277000 |
| Fax Number | 6622277534 |
Provider's Primary Taxonomy Detail
| Speciality | Skilled Nursing Facility |
|---|---|
| Taxonomy | 314000000X |
| Licence No | 11245 |
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Definition: (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring serv |
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What is the unique 10-digit identification 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) 1053386870 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you please provide the complete physical location address of Grenada Lake Medical Center?
The Grenada Lake Medical Center is physically situated at 960 Avent Dr, in the city of Grenada, state of MS, with the postal code 389015230.
What is Grenada Lake Medical Center's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Grenada Lake Medical Center is Skilled Nursing Facility, and the taxonomy classification code that categorizes this area of expertise is 314000000X.
On what date did the Centers for Medicare & Medicaid Services assign the 1053386870 to Grenada Lake Medical Center?
The Centers for Medicare & Medicaid Services assigned the 1053386870 to Grenada Lake Medical Center on 2006-02-23.
When was the Grenada Lake Medical Center's information last updated?
The Grenada Lake Medical Center's information was last updated on 2007-12-12.