McMedical Country Clinic LLC
Organization Active NPI Health Service Clinic/Center · Carrollton, MS
NPI 1760035232 · NPPES record last updated Feb 12, 2024
Key facts
- NPI
- 1760035232
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Health Service Clinic/Center 261QH0100X
- Legal business name
- MCMEDICAL COUNTRY CLINIC LLC
- Practice address
- 19441 Highway 82
Carrollton, MS 38917-7079 - Phone
- (662) 595-4114
- Fax
- (662) 595-4117
- NPI assigned
- Jul 23, 2019
- Organization subpart
- No
Authorized official
- Name
- Jessica Pamplin
- Title
- VP, Revenue Cycle MGMT
- Phone
- (601) 714-1025
Practitioners 1
-
Carol Suzanne McCrimmon, FNP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200319000625 | MS | Part B Supplier - Clinic/Group Practice | 8325476658 |
Receives reassigned benefits from 1 practitioner Practice locations: Carrollton, MS |
National Provider Directory
Locations
19441 Highway 82
Carrollton, MS 38917
Phone (662) 595-4114
52 County Road 74
Mc Carley, MS 38943
Phone (662) 237-0404
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Service Clinic/Center | 261QH0100X | Yes |
Addresses
Primary practice location
19441 Highway 82
Carrollton, MS 38917-7079
Mailing address
19441 Highway 82
Carrollton, MS 38917-7079
Phone (662) 595-4114
Other providers in Carrollton, MS
- Carroll County General Dentistry, LLC
- Richard Daniel Hill
- Jearica McBride
- Carol Suzanne McCrimmon
- Mississippi State Department of Health
- Star Care
All providers in Carrollton, MS · Health Service Clinic/Center in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 12, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.