Healthcare Provider Details

I. General information

NPI: 1700618014
Provider Name (Legal Business Name): REDMED, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2024
Last Update Date: 08/15/2024
Certification Date: 08/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 E COMMERCE ST
HERNANDO MS
38632-2456
US

IV. Provider business mailing address

12 BROOKES XING
PONTOTOC MS
38863-1009
US

V. Phone/Fax

Practice location:
  • Phone: 662-298-2238
  • Fax: 662-298-2242
Mailing address:
  • Phone: 662-489-4044
  • Fax:

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: LAURIE A. DUNCAN
Title or Position: VP OF REVENUE
Credential:
Phone: 678-332-6122