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General NPI Number Information
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NPI Number | 1821397944
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Entity Type | Organization
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Legal Business Name | SHEPHERDS
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Dates
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Enumeration Date | 03/16/2011
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Last Update Date | 03/16/2011
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Provider Practice Location Address
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Address Line | 4379 CAYCE RD
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City | BYHALIA
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State | MS
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Zip | 38611
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Country | US
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Telephone | 901-493-9355
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Fax | 662-420-7183
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Provider Business Mailing Address
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Address Line | 4379 CAYCE RD
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City | BYHALIA
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State | MS
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Zip | 38611
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Country | US
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Telephone | 901-493-9355
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Fax | 662-420-7183
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. SLAYTON TOWNS III
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Credential |
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Telephone | 901-493-9355
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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 | 4124
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License Number State | MS
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