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General NPI Number Information
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NPI Number | 1184685653
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Entity Type | Organization
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Legal Business Name | MIDSOUTH MEDICAL INC
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Dates
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Enumeration Date | 03/31/2006
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Last Update Date | 07/08/2022
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Provider Practice Location Address
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Address Line | 3209 BREARD ST
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City | MONROE
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State | LA
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Zip | 71201-3911
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Country | US
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Telephone | 318-855-0411
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Fax | 855-420-5858
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Provider Business Mailing Address
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Address Line | PO BOX 4927
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City | MONROE
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State | LA
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Zip | 71211-4927
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Country | US
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Telephone | 318-855-0411
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Fax | 855-420-5858
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Authorized Official
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Title or Position | OWNER
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Name | MS. REBECCA JONES
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Credential |
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Telephone | 318-855-0411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 35109770D
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License Number State | LA
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