Organization Name: | GREENE RURAL HEALTH CENTER |
NPI Number: | 1992982805 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ODESSA GLYNN (BUSINESS OFFICE DIRECTOR) |
Mailing Address: | 1017 Jackson Ave Leakesville |
State: | MS US |
Postal Code: | 394519105 |
Phone Number: | 6013944135 |
Fax Number: | 6013944455 |
NPI Enumeration Date: | 01/23/2008 |
NPI Last Update Date: | 07/14/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QC1500X |
License Number: | 11343 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Community Health |
Taxonomy Definition: |