# GREENE COUNTY CLINIC HOSPITAL SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** GREENE COUNTY FAMILY MEDICAL CLINIC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1467706762
- **Legal business name:** GREENE COUNTY FAMILY MEDICAL CLINIC
- **Authorized official:** SUSAN M RUTLEDGE (FINANCIAL DIRECTOR)
- **Authorized official phone:** (601) 947-1330

## Contact information

- **Practice address:** 1017 JACKSON AVE, LEAKESVILLE, MS 39451-9105
- **Practice address phone:** (601) 947-8181
- **Practice address fax:** (601) 947-4411
- **Mailing address:** PO BOX 1007, LUCEDALE, MS 39452-1007
- **Mailing address phone:** (601) 947-1330
- **Mailing address fax:** (601) 947-1331

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/08/2012
- **Last updated:** 01/17/2017