Organization
SOUTHEASTERN MEDICAL SUPPLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BARRY MAHAN (OWNER)
(606) 258-0001
Entity
Organization
Contact information
Practice address
120 N LAUREL AVE, CORBIN, KY 40701-1235
(606) 258-0001
(606) 258-0021
Mailing address
PO BOX 1565, CORBIN, KY 40702-1565
(606) 258-0001
(606) 258-0021
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
03/16/2008
Last updated
01/22/2021
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