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General NPI Number Information
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NPI Number | 1457459620
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Entity Type | Organization
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Legal Business Name | MISSISSIPPI LIMB BRACE AND DME, LLC
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 06/17/2009
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Provider Practice Location Address
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Address Line | 1815 GOVERNMENT ST
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-3942
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Country | US
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Telephone | 228-875-2466
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Fax | 228-875-2426
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Provider Business Mailing Address
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Address Line | 1815 GOVERNMENT ST
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-3942
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Country | US
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Telephone | 228-875-2466
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Fax | 228-875-2426
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Authorized Official
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Title or Position | MEMBER
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Name | MR. CLARENCE A HAMILTON III
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Credential |
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Telephone | 228-297-7152
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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 |
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