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General NPI Number Information
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NPI Number | 1821740051
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Entity Type | Organization
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Legal Business Name | MISSISSIPPI MED SUPPLY LLC
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Dates
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Enumeration Date | 01/19/2022
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Last Update Date | 01/25/2022
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Provider Practice Location Address
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Address Line | 301B HIGHWAY 72 E
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City | CORINTH
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State | MS
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Zip | 38834-6023
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Country | US
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Telephone | 662-808-0856
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1139
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City | CORINTH
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State | MS
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Zip | 38835-1139
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Country | US
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Telephone | 662-808-0856
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | GARY KEITH BARNETT
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Credential |
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Telephone | 662-808-0856
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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 |
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License Number State |
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