Organization
PRIME URGENT MEDICAL CLINIC
Active
Other names
Prime Urgent Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
CLARK LEVI (MEMBER)
(228) 447-3823
Entity
Organization
Contact information
Practice address
176 GOODMAN RD W, SOUTHAVEN, MS 38671-9405
(662) 510-6981
(662) 510-6987
Mailing address
1019 GOVERNMENT ST, SUITE F, OCEAN SPRINGS, MS 39564-3860
(288) 447-3823
(228) 447-3812
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
14440
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2153376
PK
—
Enumeration date
08/07/2015
Last updated
05/10/2016
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