Organization
METRO MEDICAL SUPPLY COMPANY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WANDA HARDEN (OWNER)
(601) 268-6939
Entity
Organization
Contact information
Practice address
5268 OLD HIGHWAY 11, SUITE 2, HATTIESBURG, MS 39402-8379
(601) 268-6939
(601) 268-6089
Mailing address
PO BOX 16595, HATTIESBURG, MS 39404-6595
(601) 268-6939
(601) 268-6089
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
037-06632-1
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00440960
—
MS
Enumeration date
07/12/2006
Last updated
06/17/2010
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