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GRENADA ADULT HEALTHCARE CLINIC PC.
NPI 1144478512
Clinic/Center - Primary Care in Grenada, MS

Active since August 28, 2008
965 J K AVENT DR, SUITE 106, GRENADA, MS 38901(662) 227-6450(662) 227-6452 Get Directions Write a Review

NPPES record last updated: August 29, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Grenada Adult Healthcare Clinic Pc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GRENADA ADULT HEALTHCARE CLINIC PC. (NPI 1144478512) is a healthcare organization registered as a primary care in Grenada, Mississippi and active in the NPI registry since August 2008. The organization lists Justice Aaron Gondwe, President, as its authorized official.

NPPES Registry Identity

NPI1144478512
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameGRENADA ADULT HEALTHCARE CLINIC PC.
Location Address965 J K AVENT DR, SUITE 106Grenada, MS 38901-5045
Mailing Address965 J K Avent Dr, Suite 106Grenada, MS 38901-5045 · (662) 227-6450 · Fax (662) 227-6452
Phone(662) 227-6450
Fax(662) 227-6452
Organization SubpartNo
Authorized OfficialJustice Aaron GondwePresident · (662) 227-6450
Enumeration DateAugust 28, 2008
Last NPPES UpdateAugust 29, 2008
✔ NPI 1144478512 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
License✔ Licensed in MS · 20373
Also ListedClinic/Center · Medical SpecialtyTaxonomy 261QM2500X · License 20373 (MS)
965 J K AVENT DR, Grenada, MS 38901
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Other Names 1

Doing Business AsGrenada Adult Healthcare Clinic Pc.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LIZA DE OLAZO BANAAG, M. D., P. A.
Preventive Medicine (Undersea and Hyperbaric Medicine)
965 J K AVENT DR, SUITE 100-A
GRENADA, MS 38901
Grenada County (662) 227-7446
DR. JUSTICE AARON GONDWE M.D.
Internal Medicine (Infectious Disease)
965 J K AVENT DR, SUITE 106
GRENADA, MS 38901
Grenada County (662) 227-6450

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Grenada Adult Healthcare Clinic PC.'s NPI number?

The NPI number for Grenada Adult Healthcare Clinic PC. is 1144478512. It was assigned to this organization in the NPPES registry on August 28, 2008.

Where is Grenada Adult Healthcare Clinic PC. located?

Grenada Adult Healthcare Clinic PC. is located at 965 J K Avent Dr Suite 106, Grenada, MS 38901. The listed phone number is (662) 227-6450.

What is Grenada Adult Healthcare Clinic PC.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

When was this NPI record last updated?

The NPPES record for Grenada Adult Healthcare Clinic PC. was last updated on August 29, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.