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Organization
LOUISVILLE MEDICAL SUPPLY INC
Active
Organization
LOUISVILLE MEDICAL SUPPLY INC
Active
Parent organization
LOUISVILLE MEDICAL SUPPLY INC
Other names
PHILADELPHIA MEDICAL SUPPLY INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
LOUISVILLE MEDICAL SUPPLY INC
Authorized official
JAN P WHITEHEAD (PRESIDENT)
(662) 803-3199
Entity
Organization
Contact information
Practice address
411 CENTER AVE N, PHILADELPHIA, MS 39350-2920
(601) 656-0802
(601) 656-0804
Mailing address
411 CENTER AVE N, PHILADELPHIA, MS 39350-2920
(601) 656-0802
(601) 656-0804
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
MS
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
MS
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
MS
Other
Enumeration date
10/07/2011
Last updated
10/07/2011
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