Healthcare Provider Details

I. General information

NPI: 1073849626
Provider Name (Legal Business Name): SSD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2009
Last Update Date: 02/10/2026
Certification Date: 02/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

498 W BANKHEAD ST
NEW ALBANY MS
38652-3319
US

IV. Provider business mailing address

PO BOX 867
NEW ALBANY MS
38652-0867
US

V. Phone/Fax

Practice location:
  • Phone: 662-534-4774
  • Fax: 665-534-4775
Mailing address:
  • Phone: 662-534-4774
  • Fax: 665-534-4775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT M BAILEY
Title or Position: OWNER
Credential:
Phone: 662-534-4774