Organization
ORTHOSPINE DME, LLC
Active
Other names
OrthoSpine DME
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID COOK (CEO/PRESIDENT)
(601) 402-3807
Entity
Organization
Contact information
Practice address
5315 OLD HIGHWAY 11 STE 4, HATTIESBURG, MS 39402-6224
(800) 484-1851
(800) 484-1851
Mailing address
5315 OLD HIGHWAY 11, STE 4, HATTIESBURG, MS 39402-6224
(800) 484-1851
(800) 484-1851
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18041-11.1
MISSISSIPPI BOARD OF PHARMACY - MEDICAL EQUIPMENT SUPPLIER LICENSE
MS
Enumeration date
04/23/2020
Last updated
04/23/2020
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