Organization
STATE OF MISSISSIPPI - UNIVERSITY OF MISSISSIPPI MEDICAL CENTER
Active
Parent organization
STATE OF MISSISSIPPI - UNIVERSITY OF MISSISSIPPI MEDICAL CENTER
Other names
UMMC Grenada Primary Medicine Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
STATE OF MISSISSIPPI - UNIVERSITY OF MISSISSIPPI MEDICAL CENTER
Authorized official
SCOTT WHITTEMORE (CFO)
(662) 227-7172
Entity
Organization
Contact information
Practice address
1300 SUNSET DR STE R, GRENADA, MS 38901-4084
(662) 227-7000
Mailing address
960 AVENT DR, GRENADA, MS 38901-5230
(662) 227-7172
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
10/23/2023
Last updated
10/23/2023
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