Healthcare Provider Details

I. General information

NPI: 1417698580
Provider Name (Legal Business Name): MEDICAL EQUIPMENT TO GO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 04/05/2022
Certification Date: 04/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 CLINTON BLVD
CLINTON MS
39056-5118
US

IV. Provider business mailing address

PO BOX 312
EDWARDS MS
39066-0312
US

V. Phone/Fax

Practice location:
  • Phone: 601-955-2387
  • Fax: 601-852-7080
Mailing address:
  • Phone: 601-955-2387
  • Fax: 601-852-7080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JEANETTE WEEDEN
Title or Position: OWNER
Credential:
Phone: 601-955-2387