Healthcare Provider Details

I. General information

NPI: 1982249447
Provider Name (Legal Business Name): REDMED, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2019
Last Update Date: 11/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

188 STARLYN AVE
NEW ALBANY MS
38652-2436
US

IV. Provider business mailing address

12 BROOKES XING
PONTOTOC MS
38863-1009
US

V. Phone/Fax

Practice location:
  • Phone: 662-486-2700
  • Fax: 662-486-2702
Mailing address:
  • Phone: 662-489-4044
  • Fax: 662-489-4041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PAT G CROSS
Title or Position: VP
Credential:
Phone: 662-231-3501