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Organization

EXECUTIVE MEDICAL SUPPLIES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MILO D COLLINS (OWNER)
(769) 798-9799
Entity
Organization

Contact information

Practice address
135 E THIRD ST, FOREST, MS 39074-4101
(601) 469-9040
Mailing address
135 E THIRD ST, FOREST, MS 39074-4101
(601) 469-9040

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
981193
MS

Other

Enumeration date
06/04/2011
Last updated
08/23/2013
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