Organization
PREMIER SURGICAL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REBEKAH ELIZABETH HENDERSON RN (OR AMINISTRATOR)
(601) 391-2525
Entity
Organization
Contact information
Practice address
160 FOUNTAINS BLVD, MADISON, MS 39110
(601) 968-8132
(601) 944-9780
Mailing address
160 FOUNTAINS BLVD STE C, MADISON, MS 39110-6380
(601) 391-2525
(601) 586-5315
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
02/07/2018
Last updated
03/12/2024
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