Organization
GREENWOOD LEFLORE HOSPITAL DME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES H JACKSON (CFO)
(662) 459-7149
Entity
Organization
Contact information
Practice address
1401 RIVER RD, GREENWOOD, MS 38930-4030
(662) 459-2613
(662) 459-1159
Mailing address
PO BOX 1410, GREENWOOD, MS 38935-1410
(662) 459-2613
(662) 459-1159
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
11065
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05730081
—
MS
Enumeration date
04/23/2007
Last updated
12/24/2008
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