Organization · NPI-2

Bc Medical LLC

Family Medicine · Vicksburg, MS

NPI number1366291627
StatusActive
Last updated in NPPESFeb 12, 2026

Details

NPI
1366291627
Entity type
Organization (NPI-2)
Legal business name
Bc Medical LLC
Organization subpart
No
Enumeration date
May 17, 2024
Certification date
Feb 12, 2026
Last updated
Feb 12, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine––Yes

Other names

  • Holy River Health (Doing Business As)

Practice location

114 Monument Pl Ste A
Vicksburg, MS 39180-5169

Phone 601-738-5075 · Fax 601-738-5197

Mailing address

114 Monument Pl Ste A
Vicksburg, MS 39180-5169

Phone 601-738-5075 · Fax 601-898-7577

Authorized official

Brandon Mizell
MD
6017385075

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