Diamond Grove Center

LBN: Diamond Grove Center
Diamond Grove Center is an health care organization with primary practice located at 2311 Highway 15 S , Louisville MS 39339-7071. The organization recently has only one registered license in Suppliers / Institutional Pharmacy, which is considered as the primary health care specialty. Diamond Grove Center can be contacted via phone (662) 779-0119, or through Swoopes, Patrick via phone (662) 779-0119.

Contact Information

Primary practice address
2311 Highway 15 S Louisville MS 39339-7071
Phone: (662) 779-0119
Fax: (662) 779-0126
Website:
Map and Directions
Authorized official contact:
Name: Swoopes, Patrick
Phone: (662) 779-0119

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Institutional Pharmacy 3336I0012X 03665 Mississippi

Profile Details

NPI number 1619000593
LBN Legal business name Diamond Grove Center
DBA Doing business as
Authorized official Swoopes, Patrick
Entity Organization
Organization subpart 1 No
Enumeration date Mar 13th, 2007
Last updated Dec 13th, 2007 - about 19 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619000593 NPPES
Mississippi Other 00020375 BLUE CROSS PROVIDER #
Mississippi Other 00330450 BLUE CROSS PROVIDER #
Mississippi MEDICAID 00220411 BLUE CROSS PROVIDER #
Mississippi MEDICAID 00220801 BLUE CROSS PROVIDER #

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