Healthcare Provider Details

I. General information

NPI: 1053482299
Provider Name (Legal Business Name): MEDICAL SUPPLIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2006
Last Update Date: 12/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 S DALTON ST
SLOCOMB AL
36375-5483
US

IV. Provider business mailing address

135 S DALTON ST P.O. BOX 580
SLOCOMB AL
36375-5483
US

V. Phone/Fax

Practice location:
  • Phone: 334-886-9111
  • Fax: 334-886-9255
Mailing address:
  • Phone: 334-886-9111
  • Fax: 334-886-9255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number126
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number900486
License Number StateAL

VIII. Authorized Official

Name: MR. JAMES ANTHONY EUBANKS
Title or Position: MANAGING PARTNER
Credential:
Phone: 334-886-9111