GRENADA LAKE MEDICAL CENTER; NPI #1386644789

Contact Information

GRENADA LAKE MEDICAL CENTER

960 AVENT DR
GRENADA, MS 38901-5230

Phone: 662-227-7000
Fax: 662-227-7534
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Rural	282NR1301X

Indicates primary specialty

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NPI Profile & details for GRENADA LAKE MEDICAL CENTER

NPI # 1386644789

LBN Legal business name GRENADA LAKE MEDICAL CENTER

Authorized official CHARLES DENTON - (CEO)

Entity Organization

Organization subpart ¹ No

Enumeration date 07/28/2005

Last updated 06/15/2012 - About 14 years ago

Identifiers

License #

11245

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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GRENADA LAKE MEDICAL CENTER

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Specialty

Rural

NPI Profile & details for GRENADA LAKE MEDICAL CENTER

Reviews for GRENADA LAKE MEDICAL CENTER