Healthcare Provider Details

I. General information

NPI: 1104934231
Provider Name (Legal Business Name): THOMPSON COMPANY OF MISSISSIPPI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 SOUTHPOINTE DR STE C
BYRAM MS
39272-5571
US

IV. Provider business mailing address

110 SOUTHPOINTE DR STE C
BYRAM MS
39272-5571
US

V. Phone/Fax

Practice location:
  • Phone: 601-346-4117
  • Fax: 601-346-4118
Mailing address:
  • Phone: 601-346-4117
  • Fax: 601-346-4118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. BRUCE LEON THOMPSON
Title or Position: OWNER
Credential:
Phone: 601-346-4117