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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

GRENADA LAKE MEDICAL CENTER

Active Organization

GRENADA LAKE MEDICAL CENTER is a Family Medicine organization located in GRENADA, Mississippi. NPI 1053684548 is currently active in the NPPES registry. Verify at CMS.

Family Medicine · GRENADA, MS

Registration Details

NPI Number
1053684548
Provider Type
Organization
NPI Issued
Feb 15, 2012 (14.489864290713 yrs)
Last Updated
Mar 18, 2014
License
21836 (MS)

Practice Information

Address
965 AVENT DR STE 100A
GRENADA, MS, 389015045
Browse MS providers · Browse ZIP 38901
Phone
6622277444
Fax
6622277443
Primary Specialty
Family Medicine
207Q00000X
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.