Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Grenada Lake Medical Center

Organization Rural Health Clinic/Center · NPI 1154506277

Grenada Lake Medical Center is a Rural Health Clinic/Center in Grenada, Mississippi. Licensed in Mississippi. Registered with an NPI since 2008.

Licensed in
MS
In the registry since
2008

Practice location Address checks out

965 Avent Dr Ste 105
Grenada, MS 38901-5045
Phone: (662) 227-7575
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Rural Health Clinic/Center (primary) Taxonomy 261QR1300X · Licence 11-245 (MS)

Record details

NPI number1154506277
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Charles Denton — Ceo · (662) 227-7005
Other names Grenada Primary Care Clinic
NPI enumeratedJanuary 8, 2008
Last updated in NPPESJanuary 8, 2008
Mailing address965 Avent Dr Ste 105, Grenada, MS 38901-5045

Other providers in Grenada