Provider Demographics
NPI:1568007094
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 1:105A QUALITY LN
Practice Address - Street 2:
Practice Address - City:SENATOBIA
Practice Address - State:MS
Practice Address - Zip Code:38668-2317
Practice Address - Country:US
Practice Address - Phone:662-298-2144
Practice Address - Fax:662-298-2145
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REDMED, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-11-07
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care