Organization
MED SOUTH, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA J WELLS (EXECUTIVE DIRECTOR)
(205) 221-8258
Entity
Organization
Contact information
Practice address
4505 HIGHWAY 78 E STE 100, JASPER, AL 35501-8882
(205) 384-3626
(205) 384-5526
Mailing address
406 MEDICAL CENTER DR, JASPER, AL 35501-3400
(205) 221-8200
(205) 221-8270
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
108347
—
AL
Enumeration date
01/03/2007
Last updated
03/24/2018
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