Healthcare Provider Details

I. General information

NPI: 1669641023
Provider Name (Legal Business Name): HEALTH CARE MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/29/2008
Last Update Date: 02/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2321 HIGHWAY 45 N
COLUMBUS MS
39705-1727
US

IV. Provider business mailing address

2321 HIGHWAY 45 N
COLUMBUS MS
39705-1727
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: VALERIE TOLLEY
Title or Position: PRESIDENT
Credential:
Phone: 601-720-0064