Healthcare Provider Details

I. General information

NPI: 1184310005
Provider Name (Legal Business Name): BEDFORD MEDICAL SUPPLY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2023
Last Update Date: 04/13/2023
Certification Date: 04/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

814 UNION ST STE A
SHELBYVILLE TN
37160-2608
US

IV. Provider business mailing address

814 UNION ST STE A
SHELBYVILLE TN
37160-2608
US

V. Phone/Fax

Practice location:
  • Phone: 931-773-3088
  • Fax: 931-773-3089
Mailing address:
  • Phone: 931-773-3088
  • Fax: 931-773-3089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: EHIS MURPHY
Title or Position: MANAGER
Credential:
Phone: 931-773-3088