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Contact Information

PRIME URGENT MEDICAL CLINIC
176 GOODMAN RD W
SOUTHAVEN, MS38671-9405
 Phone: 662-510-6981
 Fax: 662-510-6987
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinic Pharmacy

3336C0002X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for PRIME URGENT MEDICAL CLINIC

NPI # 1891171351
LBN Legal business name PRIME URGENT MEDICAL CLINIC
Authorized official CLARK LEVI - (MEMBER)
Entity Organization
Organization subpart 1 No
Enumeration date 08/07/2015
Last updated 05/10/2016 - About 10 years ago
Identifiers
MS License # 14440
Other 2153376 PK
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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