# STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER
- **Other names:** University of Mississippi Center-Grenada
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1558798603
- **Legal business name:** STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER
- **Authorized official:** MR. KEVIN COOK (CEO)
- **Authorized official phone:** (601) 984-4113

## Contact information

- **Practice address:** 960 AVENT DR, GRENADA, MS 38901-5230
- **Practice address phone:** (662) 227-7000
- **Mailing address:** 2500 NORTH STATE STREET, JACKSON, MS 39216
- **Mailing address phone:** (601) 984-4118

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | — | NULL | Yes |

## Other

- **Enumeration date:** 10/03/2013
- **Last updated:** 10/03/2013