Organization
SOUTHERN MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CRYSTAL MARIE PUGH (OWNER)
(931) 372-2109
Entity
Organization
Contact information
Practice address
1150 PERIMETER PARK DR, SUITE A, COOKEVILLE, TN 38501-0927
(931) 372-2109
(931) 372-2118
Mailing address
1150 PERIMETER PARK DR, SUITE A, COOKEVILLE, TN 38501-0927
(931) 372-2109
(931) 372-2118
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
TN
Other
Enumeration date
12/28/2006
Last updated
08/22/2020
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