Organization
DURA-MED SOUTHEAST INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACK R FLOYD (PRESIDENT)
(850) 675-2448
Entity
Organization
Contact information
Practice address
905 SHADY PINE ST, WAYNESBORO, MS 39367-2543
(601) 735-1633
(601) 735-1633
Mailing address
905 SHADY PINE ST, WAYNESBORO, MS 39367-2543
(601) 735-1633
(601) 735-1633
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
04688/11.1
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00440934
—
MS
Enumeration date
08/30/2006
Last updated
02/18/2009
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