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General NPI Number Information
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NPI Number | 1609959329
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Entity Type | Organization
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Legal Business Name | NORFOLK SUPPLY
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 05/04/2015
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Provider Practice Location Address
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Address Line | 1409 E UNION ST
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City | GREENVILLE
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State | MS
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Zip | 38703-3247
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Country | US
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Telephone | 662-335-4105
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Fax | 662-378-2879
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Provider Business Mailing Address
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Address Line | PO BOX 6000
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City | GREENVILLE
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State | MS
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Zip | 38704-6000
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Country | US
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Telephone | 662-335-4105
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Fax | 662-378-2879
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NED O. KRONFOL
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Credential | M.D.
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Telephone | 662-335-4105
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BD1200X
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Taxonomy Name | Dialysis Equipment & Supplies (DME)
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License Number |
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License Number State |
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