Organization
WOMAN'S HEALTH CLINIC OF GRENADA, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GALE H MOORE CNM (OWNER)
(662) 226-4010
Entity
Organization
Contact information
Practice address
1401 OAK ST, GRENADA, MS 38901-4633
(662) 226-4010
(662) 226-4495
Mailing address
1401 OAK STREET, GRENADA, MS 38901-4633
(662) 226-4010
(662) 226-4495
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09013808
—
MS
Enumeration date
03/20/2007
Last updated
06/23/2014
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