Healthcare Provider Details

I. General information

NPI: 1912381609
Provider Name (Legal Business Name): MVP HEALTH SYSTEMS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2015
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1907 N MEDICAL PARK DR STE 101
GREENVILLE MS
38703-7240
US

IV. Provider business mailing address

PO BOX 552
LAKE VILLAGE AR
71653-0552
US

V. Phone/Fax

Practice location:
  • Phone: 662-378-5445
  • Fax: 662-332-0195
Mailing address:
  • Phone: 662-378-5445
  • Fax: 662-332-0195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number14410/1.1
License Number StateMS

VIII. Authorized Official

Name: MRS. MICHELLE L CROUSE
Title or Position: OWNER
Credential:
Phone: 870-265-2220