Grenada Lake Medical Center
NPI #1154506277 in Grenada, Mississippi
Provider Information
- NPI Number
- 1154506277
- Entity Type
- Organization
- Organization Name
- Grenada Lake Medical Center
- Primary Specialty
- Clinic/Center - Rural Health
- Enumeration Date
- Jan 8, 2008
- Last Updated
- Jan 8, 2008
Practice Location
- Address
- 965 AVENT DR STE 105
- City
- Grenada
- State
- Mississippi
- ZIP Code
- 38901-5045
- Phone
- (662) 227-7575
Authorized Official
- Name
- MR. CHARLES L DENTON
- Title
- CEO
- Phone
- (662) 227-7005
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Rural Health — Rural Health |
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