Healthcare Provider Details

I. General information

NPI: 1558487629
Provider Name (Legal Business Name): HUNTLEIGH HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 BUSINESS PARK DR SUITE F
RIDGELAND MS
39157-6016
US

IV. Provider business mailing address

40 CHRISTOPHER WAY
EATONTOWN NJ
07724-3327
US

V. Phone/Fax

Practice location:
  • Phone: 601-956-2880
  • Fax: 601-956-2535
Mailing address:
  • Phone: 800-223-1218
  • Fax: 732-676-5305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number05602 11.1
License Number StateMS

VIII. Authorized Official

Name: MR. ROBERT S. ANGEL
Title or Position: PRES.
Credential:
Phone: 800-223-1218