Organization
GSV CARE MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MANDA GRIFFIN DNP (OWNER)
(662) 983-0422
Entity
Organization
Contact information
Practice address
400 THIRD AVENUE, HOULKA, MS 38850
(662) 568-2013
(662) 568-2023
Mailing address
400 THIRD AVENUE, HOULKA, MS 38850
(662) 568-2013
(662) 568-2023
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
R850148
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04506555
—
MS
Enumeration date
03/15/2013
Last updated
03/11/2016
Update your record
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