Healthcare Provider Details

I. General information

NPI: 1700073905
Provider Name (Legal Business Name): AVAILABLE MEDICAL SUPPLIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2007
Last Update Date: 04/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

912 HIGHWAY 15
STRINGER MS
39481-4230
US

IV. Provider business mailing address

PO BOX 128 912 HIGHWAY 15
STRINGER MS
39481-0128
US

V. Phone/Fax

Practice location:
  • Phone: 604-649-4418
  • Fax: 601-649-4487
Mailing address:
  • Phone: 604-649-4418
  • Fax: 601-649-4487

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number05068/11.1
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number05321/02.5
License Number StateMS

VIII. Authorized Official

Name: MR. LARRY CARLTON JENKINS
Title or Position: OWNER
Credential:
Phone: 601-649-4418