Provider Demographics
NPI:1376168500
Name:MS CARE CLINIC, INC
Entity Type:Organization
Organization Name:MS CARE CLINIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, NP-C
Authorized Official - Phone:601-499-0282
Mailing Address - Street 1:625 S PEAR ORCHARD RD STE B
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-4836
Mailing Address - Country:US
Mailing Address - Phone:601-499-0282
Mailing Address - Fax:601-420-0223
Practice Address - Street 1:625 S PEAR ORCHARD RD STE B
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-4836
Practice Address - Country:US
Practice Address - Phone:601-850-2200
Practice Address - Fax:601-420-0223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-12
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty