Organization
BUDE CLINIC LAB
Active
Organization
BUDE CLINIC LAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY K LARKIN (OFFICE MANAGER)
(601) 384-2394
Entity
Organization
Contact information
Practice address
136 MAIN ST N, BUDE, MS 39630
(601) 384-2394
(601) 384-4199
Mailing address
PO BOX 445, BUDE, MS 39630
(601) 384-2394
(601) 384-2395
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00116640
—
MS
Enumeration date
11/01/2006
Last updated
08/22/2020
Update your record
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