Organization
TRINITY HEALTH CARE, LLC
Active
Other names
SOUTH MAIN FAMILY MEDICAL CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARSHA T HOUK FNP (NURSE PRACTITIONER)
(662) 256-3858
Entity
Organization
Contact information
Practice address
200 MAIN ST S, AMORY, MS 38821-4218
(662) 256-3858
(662) 256-3838
Mailing address
PO BOX 463, AMORY, MS 38821-0463
(662) 256-3858
(662) 256-3838
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R797975
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09657361
—
MS
Enumeration date
10/13/2009
Last updated
11/10/2010
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