| First Intermed Corporation | |
|
106 Lake Vista Place Brandon MS 39047-0000 | |
| (601) 919-2924 | |
| Not Available |
| Full Name | First Intermed Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 106 Lake Vista Place, Brandon, Mississippi |
| Authorized Official Name and Position | Sam Scott (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 6018987525 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| First Intermed Corporation 308 Corporate Dr Ridgeland MS 39157-8803 Ph: (601) 898-7500 | First Intermed Corporation 106 Lake Vista Place Brandon MS 39047-0000 Ph: (601) 919-2924 |
| NPI Number | 1952604811 |
|---|---|
| Provider Enumeration Date | 12/15/2010 |
| Last Update Date | 12/30/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952604811 | NPI | - | NPPES |
| 4746 | Other | MS | BUSINESS LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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