Grenada Lake Medical Center
Ambulance in Grenada, MS. Organization (NPI-2).
NPI number1699005355
StatusActive
Last updated in NPPESDec 31, 2009
Details
- NPI
- 1699005355
- Entity type
- Organization (NPI-2)
- Legal business name
- Grenada Lake Medical Center
- Organization subpart
- No
- Enumeration date
- Dec 31, 2009
- Last updated
- Dec 31, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 341600000X | Ambulance | 11-245 | MS | Yes |
Practice location
960 Avent DrGrenada, MS 38901-5230
Phone 662-227-7000 · Fax 662-227-7534
Mailing address
960 Avent DrGrenada, MS 38901-5230
Phone 662-227-7000 · Fax 662-227-7534
Authorized official
Charles L Denton
Ceo
6622277000
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