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NPI 1699005355

OrganizationActive

Grenada Lake Medical Center

NPI 1699005355 · Ambulance · Grenada, MS

Provider details

NPI number: 1699005355
Entity type: Organization
Primary specialty: AmbulanceTransportation Services
Authorized official: Charles Denton, Ceo
License: 11-245 (MS)

Practice location

960 Avent Dr

Grenada, MS 38901-5230

Phone: (662) 227-7000

Fax: (662) 227-7534

More MS providers

Mailing address

960 Avent Dr

Grenada, MS 38901-5230

Registry dates

Enumerated: 2009-12-31
Last updated: 2009-12-31

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Grenada Lake Medical Center — NPI 1699005355, Grenada, MS | NPI Central