Healthcare Provider Details

I. General information

NPI: 1598093668
Provider Name (Legal Business Name): MED SUPPLY PLUS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2009
Last Update Date: 07/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2003 E SHILOH RD
CORINTH MS
38834-3726
US

IV. Provider business mailing address

2003 E SHILOH RD
CORINTH MS
38834-3726
US

V. Phone/Fax

Practice location:
  • Phone: 662-286-3107
  • Fax: 662-286-3117
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number08337/11.1
License Number StateMS

VIII. Authorized Official

Name: NATALIE SLEEPER
Title or Position: OWNER
Credential: R.PH.
Phone: 662-286-3107