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Organization

MEDI-SERV. INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JAIME T. MANGUBAT RRT (OWNER)
(931) 722-9047
Entity
Organization

Contact information

Practice address
209 SOUTH HIGH STREET, WAYNESBORO, TN 38485-0871
(931) 722-9047
(931) 722-9053
Mailing address
POB 871, WAYNESBORO, TN 38485-0871
(931) 722-9047
(931) 722-9053

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0000001745
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4058299
BCBS PROVIDER NUMBER
TN
Enumeration date
08/11/2006
Last updated
08/05/2009
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