Organization
LAUREL ADVANCED MEDICAL EQUIPMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TRACY DEWAIN WILSON (OWNER)
(601) 498-6867
Entity
Organization
Contact information
Practice address
1003 MITCHELL DR, LAUREL, MS 39440-2548
(601) 426-2178
(601) 426-2179
Mailing address
1003 MITCHELL DR, LAUREL, MS 39440-2548
(601) 426-2178
(601) 426-2179
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
12649/11.1
MS
Other
Enumeration date
09/30/2013
Last updated
05/30/2023
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