Provider Demographics
NPI:1760035232
Name:MCMEDICAL COUNTRY CLINIC LLC
Entity Type:Organization
Organization Name:MCMEDICAL COUNTRY CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, REVENUE CYCLE MGMT
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAMPLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-714-1025
Mailing Address - Street 1:19441 HIGHWAY 82
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:MS
Mailing Address - Zip Code:38917-7079
Mailing Address - Country:US
Mailing Address - Phone:662-595-4114
Mailing Address - Fax:662-595-4117
Practice Address - Street 1:19441 HIGHWAY 82
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:MS
Practice Address - Zip Code:38917-7079
Practice Address - Country:US
Practice Address - Phone:662-595-4114
Practice Address - Fax:662-595-4117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-23
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service