MEDICARE: M-D MEDICAL SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)	04553/11.1	MS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518976380
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	M-D MEDICAL SERVICES, INC.

Provider Business Mailing Address
First Line	:	1018 N FLOWOOD DR
Second Line	:
City	:	FLOWOOD
State	:	MS
Zip	:	39232-9532
Country	:	US
Telephone Number	:	601-919-9196
Fax Number	:	601-919-0609

Provider Business Practice Location Address
First Line	:	1018 N FLOWOOD DR
Second Line	:
City	:	FLOWOOD
State	:	MS
Zip	:	39232-9532
Country	:	US
Telephone Number	:	601-919-9196
Fax Number	:	601-919-0609

Authorized Official
Title or Position	:	PRESIDENT
Name	:	WADE WARD
Credential	:
Telephone Number	:	601-624-9553

Provider Enumeration Date	:	08/07/2006
Last Update Date	:	08/15/2024

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