# QUAD INTERMED COMPANY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MEA Medical Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245013424
- **Authorized official:** WILLIAM M GRANTHAM MD (CEO)
- **Authorized official phone:** (601) 898-7530

## Contact information

- **Practice address:** 112 SOUTHLAKE CIR, CANTON, MS 39046-5368
- **Practice address phone:** (601) 859-8550
- **Mailing address:** 308 CORPORATE DR, RIDGELAND, MS 39157-8803
- **Mailing address phone:** (601) 898-7530

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/14/2023
- **Last updated:** 08/14/2023