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General NPI Number Information
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NPI Number | 1275976854
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Entity Type | Organization
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Legal Business Name | SPECIALTY MEDICAL AND EQUIPMENT LLC
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Dates
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Enumeration Date | 04/12/2013
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Last Update Date | 04/12/2013
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Provider Practice Location Address
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Address Line | 1009 BYRD DR
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-3018
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Country | US
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Telephone | 228-806-7095
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Fax |
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Provider Business Mailing Address
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Address Line | 13713 MESA RD
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-2559
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Country | US
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Telephone | 228-806-7095
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MR. FELIX PETER RODRIGUE III
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Credential |
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Telephone | 228-806-7095
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | F12229
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License Number State | MS
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