Provider Demographics
NPI:1528603081
Name:REDMED, LLC
Entity Type:Organization
Organization Name:REDMED, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:PAT
Authorized Official - Middle Name:G
Authorized Official - Last Name:CROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-231-3501
Mailing Address - Street 1:12 BROOKES XING
Mailing Address - Street 2:
Mailing Address - City:PONTOTOC
Mailing Address - State:MS
Mailing Address - Zip Code:38863-1009
Mailing Address - Country:US
Mailing Address - Phone:662-489-4044
Mailing Address - Fax:662-489-4041
Practice Address - Street 1:171 LAKEWOOD DR
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:MS
Practice Address - Zip Code:38606-3014
Practice Address - Country:US
Practice Address - Phone:662-655-0311
Practice Address - Fax:769-237-4073
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REDMED, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-11-08
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care