Healthcare Provider Details

I. General information

NPI: 1942298740
Provider Name (Legal Business Name): 280 MEDICAL SUPPLY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2005
Last Update Date: 06/23/2021
Certification Date: 06/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11600 OLD HIGHWAY 280
CHELSEA AL
35043-3000
US

IV. Provider business mailing address

11600 OLD HIGHWAY 280
CHELSEA AL
35043-3000
US

V. Phone/Fax

Practice location:
  • Phone: 205-678-8755
  • Fax: 888-611-8229
Mailing address:
  • Phone: 205-678-8755
  • Fax: 888-611-8229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number652
License Number StateAL

VIII. Authorized Official

Name: MS. GEORGIA A LAY
Title or Position: PRESIDENT
Credential: A.D.S.
Phone: 205-678-8755