Healthcare Provider Details

I. General information

NPI: 1356671242
Provider Name (Legal Business Name): MEDICAL SUPPLIES UNLIMITED INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2009
Last Update Date: 12/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

853 WILSON DR
RIDGELAND MS
39157-4506
US

IV. Provider business mailing address

122 DEVLIN DR
MADISON MS
39110-6558
US

V. Phone/Fax

Practice location:
  • Phone: 601-540-4910
  • Fax: 601-605-4908
Mailing address:
  • Phone: 601-540-4910
  • Fax: 601-605-4908

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN D POWELL
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 601-540-4910