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Organization

STATE OF MISSISSIPPI- UNIVERSITY OF MISSISSIPPI MEDICAL CENTER

Active
Parent organization
STATE OF MISSISSIPPI- UNIVERSITY OF MISSISSIPPI MEDICAL CENTER
Other names
Holmes County Family Medicine- Vaiden
Organization subpart
Yes

Provider details

NPI number
Legal business name
STATE OF MISSISSIPPI- UNIVERSITY OF MISSISSIPPI MEDICAL CENTER
Authorized official
MR. JEFFREY GRIMSLEY (ASST. CFO)
(601) 985-9181
Entity
Organization

Contact information

Practice address
201A MAGNOLIA ST, VAIDEN, MS 39176-5644
(601) 496-5400
Mailing address
201A MAGNOLIA ST, VAIDEN, MS 39176-5644
(662) 496-5400

Taxonomy

Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary

Other

Enumeration date
05/19/2017
Last updated
05/19/2017
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