Organization
SOUTHERN ILLINOIS SURGICAL APPLIANCE COMPANY
Active
Parent organization
SOUTHERN ILLINOIS APPLIANCE COMPANY
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHERN ILLINOIS APPLIANCE COMPANY
Authorized official
MR. RALPH RANDOLPH LEWIS (PRESIDENT/OWNER)
(800) 642-0501
Entity
Organization
Contact information
Practice address
8305 EXPRESS DR. C, MARION, IL 62959-6359
(618) 969-8010
(618) 969-8014
Mailing address
8305 EXPRESS DR. -C, MARION, IL 62959-6359
(618) 969-8010
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Enumeration date
01/22/2008
Last updated
07/22/2009
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