Organization
MILLPORT HOLDINGS DME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT E SWANSON JR. (OWNER)
(205) 662-3862
Entity
Organization
Contact information
Practice address
13530 HWY 96, MILLPORT, AL 35576
(205) 662-3862
Mailing address
PO BOX 308, 13530 HWY 96, MILLPORT, AL 35576
(205) 662-3862
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
168697625
BLUE CROSS BLUE SHELD
AL
Enumeration date
11/21/2014
Last updated
07/23/2015
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