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Organization

MEDLINE 1 LLC

Active
Other names
Medline 1 LLC, Medline 1 LLC
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. JUANITA MARIE LUNDY (OWNER)
(901) 268-8899
Entity
Organization

Contact information

Practice address
4440 LIVERPOOL LN, SOUTHAVEN, MS 38671-7512
(901) 268-8899
Mailing address
4440 LIVERPOOL LN, SOUTHAVEN, MS 38671-7512
(901) 268-8899

Taxonomy

Speciality
Code
Description
License number
State
347E00000X
Transportation Broker
Primary
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
837X0
MS
Enumeration date
07/30/2018
Last updated
07/30/2018
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