Organization
KILMICHAEL MEDICAL SUPPLIERS INC
Active
Other names
InHealth Medical Suppliers
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEITH W WAKE (PRESIDENT)
(662) 283-1551
Entity
Organization
Contact information
Practice address
107 N FRONT STREET, WINONA, MS 38967
(662) 283-1551
(662) 283-2332
Mailing address
PO BOX 185, KILMICHAEL, MS 39747
(662) 283-1551
(662) 283-2332
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00330316
PHARMACY
MS
05
—
00440411
—
MS
Enumeration date
08/23/2006
Last updated
04/02/2008
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