Organization
LONGWIND PRODUCT & SERVICE, INC
Active
Organization
LONGWIND PRODUCT & SERVICE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LONNIE WALKER (CEO)
(601) 366-2215
Entity
Organization
Contact information
Practice address
205 W WOODROW WILSON AVE, JACKSON, MS 39213-7647
(601) 366-2215
(601) 366-9813
Mailing address
PO BOX 11838, JACKSON, MS 39283-1838
(601) 366-2215
(601) 366-9813
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
06693/11.1
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00440160
—
MS
Enumeration date
07/08/2006
Last updated
05/20/2008
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