Provider Demographics
NPI:1740259282
Name:GREENWOOD LEFLORE HOSPITAL
Entity type:Organization
Organization Name:GREENWOOD LEFLORE HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-459-7000
Mailing Address - Street 1:803 1ST ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:MS
Mailing Address - Zip Code:38732-2309
Mailing Address - Country:US
Mailing Address - Phone:662-843-2721
Mailing Address - Fax:
Practice Address - Street 1:803 1ST ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:MS
Practice Address - Zip Code:38732-2309
Practice Address - Country:US
Practice Address - Phone:662-843-2721
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GREENWOOD LEFLORE HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-03-16
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty