Organization
YAZOO MEDICAL SUPPLY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STACEY JONES RHIA (SECRETARY/TREASURER)
(662) 746-5677
Entity
Organization
Contact information
Practice address
805 1/2 EAST 15TH STREET, YAZOO CITY, MS 39194
(662) 746-5677
(662) 746-5676
Mailing address
805 1/2 EAST 15TH STREET, YAZOO CITY, MS 39194
(662) 746-5677
(662) 746-5676
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
MS
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
MS
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000012696
BLUE CROSS/BLUE SHIELD ID
MS
05
—
00040344
—
MS
Enumeration date
07/06/2006
Last updated
07/21/2022
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