Organization
SOUTH MISSISSIPPI HEALTH CARE
Active
Other names
Southern Medical Supply
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES DAVID COOK M.B.A. (PRESIDENT)
(601) 544-5922
Entity
Organization
Contact information
Practice address
2401 HARDY ST, SUITE 20, HATTIESBURG, MS 39401-5912
(601) 544-5922
(601) 544-5923
Mailing address
2401 HARDY ST, SUITE 20, HATTIESBURG, MS 39401-5912
(601) 544-5922
(601) 544-5923
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09622040
—
MS
Enumeration date
11/17/2006
Last updated
08/22/2020
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