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General NPI Number Information
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NPI Number | 1841441755
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Entity Type | Organization
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Legal Business Name | MC MEDICAL, INC.
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Dates
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Enumeration Date | 10/09/2008
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Last Update Date | 10/09/2008
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Provider Practice Location Address
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Address Line | 55 98 PLACE BLVD
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City | HATTIESBURG
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State | MS
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Zip | 39402-8602
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Country | US
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Telephone | 601-264-0848
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Fax | 601-264-0886
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Provider Business Mailing Address
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Address Line | 55 98 PLACE BLVD
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City | HATTIESBURG
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State | MS
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Zip | 39402-8602
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Country | US
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Telephone | 601-264-0848
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Fax | 601-264-0886
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MARILYN MULLINS
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Credential |
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Telephone | 601-587-0173
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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 | 02767/11.1
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License Number State | MS
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