Healthcare Provider Details

I. General information

NPI: 1841372182
Provider Name (Legal Business Name): FAMILY MEDICAL EQUIPMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 05/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 RIPLEY AVE
ASHLAND MS
38603-7220
US

IV. Provider business mailing address

PO BOX 374
ASHLAND MS
38603-0374
US

V. Phone/Fax

Practice location:
  • Phone: 662-224-3999
  • Fax: 662-224-3999
Mailing address:
  • Phone: 662-224-3999
  • Fax: 662-224-3999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1415
License Number StateMS

VIII. Authorized Official

Name: MRS. SHERI SHOUP
Title or Position: OWNER
Credential:
Phone: 662-224-3999