GRENADA LAKE MEDICAL CENTER NPI 1699005355

NPI Information

NPI: 1699005355
Provider Name: GRENADA LAKE MEDICAL CENTER
Classification: Ambulance - 341600000X
Entity Type: Organization
Address:
960 AVENT DR
GRENADA, MS
ZIP 38901
Phone: (662) 227-7000
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GRENADA LAKE MEDICAL CENTER is an ambulance in Grenada, MS. The provider is an emergency vehicle used for transporting patients to a health care facility after injury or illness. Types of ambulances used in the United States include ground (surface) ambulance, rotor-wing (helicopter), and fixed-wing aircraft (airplane). GRENADA LAKE MEDICAL CENTER NPI is 1699005355. The provider is registered as an organization entity type.

The provider's business location address is:

960 AVENT DR
GRENADA, MS
ZIP 38901-230
Phone: (662) 227-7000
Fax: (662) 227-7534

The provider's authorized official is Charles L Denton .
The authorized official title is Ceo and has the following contact phone number (662) 227-7000.

The enumeration date for this NPI number is 12/31/2009 and was last updated on 12/31/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	341600000X	Ambulance		11-245	MISSISSIPPI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00050795	MEDICAID	MISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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