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Organization
GREENE RURAL HEALTH CENTER
Active
Organization
GREENE RURAL HEALTH CENTER
Active
Other names
GREENE FAMILY MEDICAL CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ODESSA GLYNN (BUSINESS OFFICE DIRECTOR)
(601) 394-4135
Entity
Organization
Contact information
Practice address
1017 JACKSON AVE, LEAKESVILLE, MS 39451-9105
(601) 394-4135
(601) 394-4455
Mailing address
1017 JACKSON AVE, LEAKESVILLE, MS 39451-9105
(601) 394-4135
(601) 394-4455
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
11343
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02255270
—
MS
05
—
04428516
—
MS
05
—
06200741
—
MS
Enumeration date
01/23/2008
Last updated
07/14/2008
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