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General NPI Number Information
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NPI Number | 1629009063
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Entity Type | Organization
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Legal Business Name | AVRITT MEDICAL EQUIPMENT, INC.
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 06/14/2012
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Provider Practice Location Address
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Address Line | 909 DESOTO AVE
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City | CLARKSDALE
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State | MS
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Zip | 38614-6930
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Country | US
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Telephone | 662-627-7702
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Fax | 662-627-7889
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Provider Business Mailing Address
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Address Line | 4020 HIGHWAY 8
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City | CLEVELAND
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State | MS
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Zip | 38732-8551
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Country | US
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Telephone | 662-843-7007
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Fax | 662-843-7071
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHARLES R AVRITT
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Credential |
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Telephone | 662-843-7007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 0390111.1
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License Number State | MS
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