Organization
BORDERS-BLACKWELL MEDICAL & WELLNESS CORPORATION
Active
Other names
Trinity Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANNIE BORDERS-BLACKWELL D.O. (CEO/PHYSICIAN)
(662) 843-8700
Entity
Organization
Contact information
Practice address
321 S SHARPE AVE, POST OFFICE BOX 1998, CLEVELAND, MS 38732
(662) 843-8700
(662) 843-9100
Mailing address
321 S SHARPE AVE, POST OFFICE BOX 1998, CLEVELAND, MS 38732
(662) 843-8700
(662) 843-9100
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
20725
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07079055
—
MS
Enumeration date
08/12/2008
Last updated
06/16/2015
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