Organization
PREMIER MEDICAL CLINIC OF GREENVILLE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATHERINE COLBERT CPC (BUSINESS MANAGER)
(662) 332-8848
Entity
Organization
Contact information
Practice address
1504 HOSPITAL ST, GREENVILLE, MS 38703-3219
(662) 378-9929
(662) 378-9926
Mailing address
PO BOX 4577, GREENVILLE, MS 38704-4577
(662) 332-8848
(662) 332-8854
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
14161
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00114839
—
MS
Enumeration date
06/11/2013
Last updated
06/11/2013
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