Healthcare Provider Details

I. General information

NPI: 1447324173
Provider Name (Legal Business Name): TOLLEY VALERIE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 09/11/2025
Certification Date: 10/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

818 2ND AVE NORTH
COLUMBUS MS
39701
US

IV. Provider business mailing address

371 TOWNE CENTER BLVD
RIDGELAND MS
39157-4833
US

V. Phone/Fax

Practice location:
  • Phone: 662-329-5001
  • Fax: 662-244-5489
Mailing address:
  • Phone: 601-420-0064
  • Fax: 601-420-0223

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number06391111
License Number StateMS

VIII. Authorized Official

Name: MRS. VALERIE J HARDEN
Title or Position: OWNER
Credential:
Phone: 601-420-0064