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NPI Code Detail

MEDICARE: SANDERS VITAL CARE INC

MEDICARE: SANDERS VITAL CARE 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
1332BC3200XCustomized Equipment (DME)01568011MS
2332BN1400XNursing Facility Supplies (DME)01568011MS
3332BP3500XParenteral & Enteral Nutrition Supplies (DME)01568011MS
4332BX2000XOxygen Equipment & Supplies (DME)01568011MS
5333600000XPharmacy01568011MS
63336C0003XCommunity/Retail Pharmacy01568011MS
73336H0001XHome Infusion Therapy Pharmacy01568011MS
83336I0012XInstitutional Pharmacy01568011MS
93336L0003XLong Term Care Pharmacy01568011MS
103336M0002XMail Order Pharmacy01568011MS
113336S0011XSpecialty Pharmacy01568011MS
12332B00000XDurable Medical Equipment & Medical Supplies01568011MS

Other Identifiers

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

General Provider Information

NPI Number : 1932133535
Entity Type Code : Organization
Provider Name (Legal Business Name) : SANDERS VITAL CARE INC
Provider Business Mailing Address
First Line : 1427 S MAIN ST
Second Line :
City : GREENVILLE
State : MS
Zip : 38701-7000
Country : US
Telephone Number : 662-378-2060
Fax Number : 662-332-9966
Provider Business Practice Location Address
First Line : 1427 S MAIN ST
Second Line :
City : GREENVILLE
State : MS
Zip : 38701-7000
Country : US
Telephone Number : 662-378-2060
Fax Number : 662-332-9966
Authorized Official
Title or Position : PRESIDENT
Name : WYNN SANDERS
Credential :
Telephone Number : 662-378-2060
Provider Enumeration Date : 07/10/2006
Last Update Date : 01/31/2011

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1427 S MAIN STREET , SUITE 145
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38701-7000
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Practice Fax: 662-843-4550

Directions to “SANDERS VITAL CARE INC ” Practice Location

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