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Organization
PRIME URGENT MEDICAL CLINIC
Active
Organization
PRIME URGENT MEDICAL CLINIC
Active
Other names
Prime Urgent Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
CLARK LEVI (MEMBER)
(228) 447-3823
Entity
Organization
Contact information
Practice address
176 GOODMAN RD W, SOUTHAVEN, MS 38671-9405
(662) 510-6981
(662) 510-6987
Mailing address
1019 GOVERNMENT ST, SUITE F, OCEAN SPRINGS, MS 39564-3860
(288) 447-3823
(228) 447-3812
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
14440
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2153376
PK
—
Enumeration date
08/07/2015
Last updated
05/10/2016
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