Healthcare Provider Details

I. General information

NPI: 1063536852
Provider Name (Legal Business Name): HARRIS MEDICAL SUPPLY GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 AVIGNON DR SUITE 3
RIDGELAND MS
39157-5166
US

IV. Provider business mailing address

PO BOX 806
RIDGELAND MS
39158-0806
US

V. Phone/Fax

Practice location:
  • Phone: 601-427-2469
  • Fax: 866-860-3857
Mailing address:
  • Phone: 601-427-2469
  • Fax: 866-860-3857

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. TERRIS CATON HARRIS
Title or Position: CEO
Credential: J.D., LL.M.
Phone: 601-427-2469