Organization
SOUTHERN MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAY BLANKENSHIP (OWNER)
(270) 606-0663
Entity
Organization
Contact information
Practice address
625 KENTUCKY 980, SCOTTSVILLE, KY 42164
(270) 239-3200
Mailing address
625 VETERANS MEMORIAL HWY, SCOTTSVILLE, KY 42164
(270) 239-3200
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
MG0842
KY
Other
Enumeration date
12/27/2012
Last updated
05/17/2013
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