Organization
AT HOME MEDICAL SUPPLY OF HOLLY SPRINGS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUE OAKLEY (STORE MANAGER)
(800) 748-9148
Entity
Organization
Contact information
Practice address
621 HIGHWAY 7 S, BOX C, HOLLY SPRINGS, MS 38635-9108
(800) 748-9148
(662) 252-2320
Mailing address
621 HIGHWAY 7 S, BOX C, HOLLY SPRINGS, MS 38635-9108
(800) 748-9148
(662) 252-2320
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
03810/11.1
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00440674
—
MS
Enumeration date
06/30/2005
Last updated
08/22/2020
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