| Organization Name: | GLOVER PRIMARY CARE CLINIC |
| NPI Number: | 1063849578 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SARITA GLOVERJACKSON (FAMILY NURSE PRACTITIONER/OWNER) |
| Mailing Address: | 403 Nw Depot St Durant |
| State: | MS US |
| Postal Code: | 390633705 |
| Phone Number: | 6623161334 |
| Fax Number: | |
| NPI Enumeration Date: | 09/28/2013 |
| NPI Last Update Date: | 09/28/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | R856333 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |