Organization
PEACH CREEK PLANTING CO.,INC.
Active
Other names
Standard Oxygen
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN KELLY THOMAS III (PURCHASING AGENT)
(662) 534-4774
Entity
Organization
Contact information
Practice address
498 W BANKHEAD ST, NEW ALBANY, MS 38652-3319
(662) 534-4774
(662) 534-4775
Mailing address
PO BOX 867, NEW ALBANY, MS 38652-0867
(662) 534-4774
(662) 534-4775
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
04919/11.1
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00440727
—
MS
Enumeration date
08/17/2006
Last updated
08/22/2020
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