Organization
BLACKWATER MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES F COLLINS (PRESIDENT)
(601) 264-0059
Entity
Organization
Contact information
Practice address
1 LINCOLN PKWY, SUITE #305, HATTIESBURG, MS 39402-3262
(601) 264-0059
(866) 691-3186
Mailing address
1 LINCOLN PKWY, SUITE #305, HATTIESBURG, MS 39402-3262
(601) 264-0059
(866) 691-3186
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
05/11/2009
Last updated
05/11/2009
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