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General NPI Number Information
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NPI Number | 1417966722
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Entity Type | Organization
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Legal Business Name | RAYE MEDICAL MANAGEMENT
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 02/11/2008
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Provider Practice Location Address
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Address Line | 815 REBECCA AVE
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City | HATTIESBURG
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State | MS
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Zip | 39401-3930
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Country | US
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Telephone | 601-450-4244
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Fax |
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Provider Business Mailing Address
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Address Line | 815 REBECCA AVE
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City | HATTIESBURG
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State | MS
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Zip | 39401-3930
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Country | US
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Telephone | 601-450-4244
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MARTHA K. MCMAHAN
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Credential |
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Telephone | 601-268-3883
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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 |
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License Number State | MS
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