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GRENADA LAKE MEDICAL CENTER NPI 1326109505


NPI Information

NPI: 1326109505
Provider Name: GRENADA LAKE MEDICAL CENTER
Classification: General Acute Care Hospital - 282N00000X
Entity Type: Organization
Address:
960 J K AVENT DR
GRENADA, MS
ZIP 38901
Phone: (662) 227-7000
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GRENADA LAKE MEDICAL CENTER is a general acute care hospital in Grenada, MS. The provider is an acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. GRENADA LAKE MEDICAL CENTER NPI is 1326109505. The provider is registered as an organization entity type.

The provider's business location address is:

960 J K AVENT DR
GRENADA, MS
ZIP 38901
Phone: (662) 227-7000
Fax: (662) 227-6538

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 12/12/2006 and was last updated on 8/10/2012.


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
1282N00000XGeneral Acute Care Hospital11-245MISSISSIPPIYes

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
1C00186MEDICARE ID-TYPE UNSPECIFIEDMISSISSIPPICAHABA MCR PART B EEG EKG
2000019026OTHERMISSISSIPPIBX PROF FEE #
309011014MEDICAIDMISSISSIPPI

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

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