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1600 22nd Avenue Medical Towers 3, 3rd Floor, Suite B Meridian MS 39301 | |
(601) 703-8370 | |
(601) 703-8397 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1600 22nd Avenue, Meridian, Mississippi |
Authorized Official Name and Position | Gregory M Duckett (SR VP / CLO) |
Authorized Official Contact | 9012275233 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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2124 14th St Meridian MS 39301-4040 Ph: (601) 703-3480 | 1600 22nd Avenue Medical Towers 3, 3rd Floor, Suite B Meridian MS 39301 Ph: (601) 703-8370 |
NPI Number | 1598105447 |
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Provider Enumeration Date | 06/25/2013 |
Last Update Date | 08/16/2024 |
Medicare PECOS PAC ID | 4284548025 |
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Medicare Enrollment ID | O20130823000627 |
Identifier | Type | State | Issuer |
---|---|---|---|
1598105447 | NPI | - | NPPES |
00574313 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Greater Meridian Health Clinic, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2701 Davis St, Meridian, MS 39301 Phone: 601-693-0118 Fax: 844-778-8922 | |
Greater Meridian Health Clinic, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2701 Davis St, Meridian, MS 39301 Phone: 601-693-0118 Fax: 844-778-8922 | |
Primary Medical Services Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5000 Highway 39 N, Meridian, MS 39301 Phone: 601-646-0898 | |