Organization
FAMILY HEALTH CLINIC OF GRENADA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HENRY BRISTER (OWNER)
(662) 226-0110
Entity
Organization
Contact information
Practice address
1117 SUNSET DR STE 104, GRENADA, MS 38901-4080
(662) 226-0110
(662) 226-3700
Mailing address
1117 SUNSET DR STE 104, GRENADA, MS 38901-4080
(662) 226-0110
(662) 226-3700
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
R742805
MS
363LF0000X
Family Nurse Practitioner
Primary
R875035
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01476010
—
MS
Enumeration date
11/13/2007
Last updated
12/01/2016
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us