| Quad Intermed Company Llc | |
|
112 Southlake Cir Canton MS 39046-5368 | |
| (601) 859-8550 | |
| Not Available |
| Full Name | Quad Intermed Company Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 112 Southlake Cir, Canton, Mississippi |
| Authorized Official Name and Position | William M Grantham (CEO) |
| Authorized Official Contact | 6018987530 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Quad Intermed Company Llc 308 Corporate Dr Ridgeland MS 39157-8803 Ph: (601) 898-7530 | Quad Intermed Company Llc 112 Southlake Cir Canton MS 39046-5368 Ph: (601) 859-8550 |
| NPI Number | 1245013424 |
|---|---|
| Provider Enumeration Date | 08/14/2023 |
| Last Update Date | 08/14/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245013424 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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Magnolia Medical Clinics Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1171 Hart St, Canton, MS 39046 Phone: 601-859-9888 Fax: 601-859-9004 | |
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