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Organization
SOUTH MISSISSIPPI HEALTH CARE
Active
Organization
SOUTH MISSISSIPPI HEALTH CARE
Active
Other names
Southern Medical Supply
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES DAVID COOK M.B.A. (PRESIDENT)
(601) 544-5922
Entity
Organization
Contact information
Practice address
2401 HARDY ST, SUITE 20, HATTIESBURG, MS 39401-5912
(601) 544-5922
(601) 544-5923
Mailing address
2401 HARDY ST, SUITE 20, HATTIESBURG, MS 39401-5912
(601) 544-5922
(601) 544-5923
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09622040
—
MS
Enumeration date
11/17/2006
Last updated
08/22/2020
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