# GRENADA DIAGNOSTIC RADIOLOGY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184685448
- **Authorized official:** DR. RALPH C ARMSTRONG M.D. (ADMINISTRATOR)
- **Authorized official phone:** (662) 226-9279

## Contact information

- **Practice address:** 1300 SUNSET DR, SUITE U, GRENADA, MS 38901-4086
- **Practice address phone:** (662) 226-9279
- **Practice address fax:** (662) 226-9779
- **Mailing address:** 1300 SUNSET DR, SUITE U, GRENADA, MS 38901-4086
- **Mailing address phone:** (662) 226-9279
- **Mailing address fax:** (662) 226-9779

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 222008 | MS | Yes |

## Other

- **Enumeration date:** 03/28/2006
- **Last updated:** 12/23/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00125988 | — | MS |