Organization
VISTA MED-SUPPLY, INC.
Active
Organization
VISTA MED-SUPPLY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN D HUIE (MANAGER)
(205) 625-3099
Entity
Organization
Contact information
Practice address
110 2ND AVE E, ONEONTA, AL 35121-1714
(205) 625-3099
(205) 625-3101
Mailing address
110 2ND AVE E, ONEONTA, AL 35121-1714
(205) 625-3099
(205) 625-3101
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
409
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00440612
MS MEDICAID
MS
05
—
009104060
—
AL
01
—
51057020
BLUE CROSS AND BLUE SHIEL
AL
Enumeration date
11/15/2005
Last updated
06/19/2008
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