Healthcare Provider Details

I. General information

NPI: 1588711634
Provider Name (Legal Business Name): STONE MEDCO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3706 RIVER BEND ROAD
LUDLOW MS
39098
US

IV. Provider business mailing address

PO BOX 125
LUDLOW MS
39098-0125
US

V. Phone/Fax

Practice location:
  • Phone: 601-540-7404
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code332BD1200X
TaxonomyDialysis Equipment & Supplies (DME)
License Number
License Number StateMS
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number StateMS
# 4
Primary TaxonomyY
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number StateMS

VIII. Authorized Official

Name: ANDY STONE
Title or Position: PRESIDENT
Credential:
Phone: 601-540-7404