Healthcare Provider Details

I. General information

NPI: 1760429658
Provider Name (Legal Business Name): SYNCHRONOUS MEDICAL SUPPLY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2844 TRACELAND DR
TUPELO MS
38801-4200
US

IV. Provider business mailing address

PO BOX 3667
TUPELO MS
38803-3667
US

V. Phone/Fax

Practice location:
  • Phone: 662-690-4046
  • Fax: 662-844-6558
Mailing address:
  • Phone: 662-690-4046
  • Fax: 662-844-6558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number StateMS

VIII. Authorized Official

Name: MR. ROSS GIRARD KUNS II
Title or Position: MANAGER
Credential:
Phone: 662-690-4046