Organization
FIRST INTERMED CORPORATION
Active
Other names
MEA Medical Clinics
Organization subpart
No
Provider details
NPI number
Authorized official
SAM SCOTT (CHIEF FINANCIAL OFFICER)
(601) 898-7525
Entity
Organization
Contact information
Practice address
106 LAKE VISTA PLACE, BRANDON, MS 39047-0000
(601) 919-2924
Mailing address
308 CORPORATE DR, RIDGELAND, MS 39157-8803
(601) 898-7500
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4746
BUSINESS LICENSE
MS
Enumeration date
12/15/2010
Last updated
12/30/2010
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