Healthcare Provider Details

I. General information

NPI: 1366513343
Provider Name (Legal Business Name): ALLPHARM INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 04/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141A ENTERPRISE DR
MADISON MS
39110-8746
US

IV. Provider business mailing address

141A ENTERPRISE DR
MADISON MS
39110-8746
US

V. Phone/Fax

Practice location:
  • Phone: 877-607-3252
  • Fax: 888-947-4276
Mailing address:
  • Phone: 877-607-3252
  • Fax: 888-947-4276

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number07004/06.1
License Number StateMS

VIII. Authorized Official

Name: JAYMIE EASTERLING
Title or Position: ADMINISTRATOR
Credential:
Phone: 601-607-3252