Organization
GREENE RURAL HEALTH CENTER
Active
Other names
GREENE FAMILY MEDICAL CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ODESSA GLYNN (BUSINESS OFFICE DIRECTOR)
(601) 394-4135
Entity
Organization
Contact information
Practice address
1017 JACKSON AVE, LEAKESVILLE, MS 39451-9105
(601) 394-4135
(601) 394-4455
Mailing address
1017 JACKSON AVE, LEAKESVILLE, MS 39451-9105
(601) 394-4135
(601) 394-4455
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
11343
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02255270
—
MS
05
—
04428516
—
MS
05
—
06200741
—
MS
Enumeration date
01/23/2008
Last updated
07/14/2008
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