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General NPI Number Information
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NPI Number | 1568609196
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Entity Type | Organization
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Legal Business Name | DURABLE SUPPLY
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Dates
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Enumeration Date | 01/20/2009
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Last Update Date | 02/09/2017
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Provider Practice Location Address
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Address Line | 1807 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 | 228-872-1386
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Fax | 228-872-1389
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Provider Business Mailing Address
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Address Line | 1807 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 | 228-872-1386
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Fax | 228-872-1389
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Authorized Official
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Title or Position | OWNER
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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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