Organization
FULL POTENTIAL SENIOR SOLUTIONS
Active
Other names
Full Potential Medical Supply
Organization subpart
No
Provider details
NPI number
Authorized official
TAMEKIA RENIX JACKSON RN (CEO)
(662) 563-0670
Entity
Organization
Contact information
Practice address
405 HIGHWAY 51 S, BATESVILLE, MS 38606-2549
(662) 563-0670
(662) 563-7304
Mailing address
405 HIGHWAY 51 S, BATESVILLE, MS 38606-2549
(662) 563-0670
(662) 563-7304
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
15048/11.1
MS
Other
Enumeration date
11/28/2016
Last updated
11/28/2016
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