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NPI Code Detail

MEDICARE: QUAD INTERMED COMPANY LLC

MEDICARE: QUAD INTERMED COMPANY LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261Q00000XClinic/Center

General Provider Information

NPI Number : 1982487161
Entity Type Code : Organization
Provider Name (Legal Business Name) : QUAD INTERMED COMPANY LLC
Provider Business Mailing Address
First Line : 308 CORPORATE DR
Second Line :
City : RIDGELAND
State : MS
Zip : 39157-8803
Country : US
Telephone Number : 601-898-7530
Fax Number :
Provider Business Practice Location Address
First Line : 7300 S SIWELL RD
Second Line :
City : BYRAM
State : MS
Zip : 39272-9772
Country : US
Telephone Number : 601-373-1234
Fax Number :
Authorized Official
Title or Position : CEO
Name : WILLIAM M GRANTHAM
Credential : MD
Telephone Number : 601-898-7530
Provider Enumeration Date : 08/14/2023
Last Update Date : 08/14/2023

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Directions to “QUAD INTERMED COMPANY LLC ” Practice Location

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