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General NPI Number Information
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NPI Number | 1932197779
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Entity Type | Organization
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Legal Business Name | GREENVILLE FAMILY MEDICAL CENTER INC
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Dates
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Enumeration Date | 10/06/2005
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 1467 HIGHWAY 1 S
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City | GREENVILLE
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State | MS
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Zip | 38701-7141
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Country | US
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Telephone | 662-335-1621
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Fax | 662-335-8128
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Provider Business Mailing Address
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Address Line | 1467 HIGHWAY 1 S
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City | GREENVILLE
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State | MS
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Zip | 38701-7141
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Country | US
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Telephone | 662-335-1621
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Fax | 662-335-8128
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Authorized Official
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Title or Position | PRESIDENT/PHYSICIAN
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Name | DR. JOE S PULLIAM
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Credential | M. D.
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Telephone | 662-335-1621
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number |
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License Number State | MS
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