OrganizationActive
Glendale Healthcare, LLC
NPI 1063188167 · Primary Care Clinic/Center · Hattiesburg, MS
Provider details
- NPI number
- 1063188167
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Akwasi Amponsah, Ceo(314) 435-6386
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
2503 Glendale Ave
Hattiesburg, MS 39401-1073
Phone: (601) 582-5805
Approximate (ZIP-level) locationGet directions
Mailing address
2503 Glendale Ave
Hattiesburg, MS 39401-1073
Registry dates
- Enumerated
- 2021-08-18
- Last updated
- 2021-08-18
- Certified
- 2021-08-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.