Golden Age Clinic
LBN: Golden Age Inc
Golden Age Clinic is an health care organization with primary practice located at 2901 Highway 82 E , Greenwood MS 38930-2960. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Ambulatory Health Care Facilities / Rural Health. Ambulatory Health Care Facilities / Rural Health is the primary health care specialty.
Golden Age Inc can be contacted via phone (662) 374-2185, or through Watkins, Tabatha Danielle via phone (662) 453-6323.
Contact Information
Primary practice address
2901 Highway 82 E
Greenwood MS 38930-2960
Phone: (662) 374-2185
Fax: (662) 374-2195
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ||
| Ambulatory Health Care Facilities / Rural Health | 261QR1300X | Mississippi |
Profile Details
| NPI number | 1558693671 |
|---|---|
| LBN Legal business name | Golden Age Inc |
| DBA Doing business as | Golden Age Clinic |
| Authorized official | Watkins, Tabatha Danielle |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Feb 1st, 2010 |
| Last updated | Jan 6th, 2022 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558693671 | NPPES |
| Mississippi | MEDICAID | 09705072 |
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