Organization
MED-MART HOME CARE INC
Active
Parent organization
MED-MART HOME CARE INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MED-MART HOME CARE INC
Authorized official
MR. THOMAS ASHLEY BUTLER (VICE PRESIDENT)
(662) 489-9330
Entity
Organization
Contact information
Practice address
211 N MAIN ST, WATER VALLEY, MS 38965-2504
(662) 473-4426
(662) 473-4427
Mailing address
211 N MAIN ST, WATER VALLEY, MS 38965-2504
(662) 473-4426
(662) 473-4427
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1132590001
MS
332BX2000X
Oxygen Equipment & Supplies (DME)
1132590001
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0440402
—
MS
Enumeration date
04/09/2008
Last updated
09/08/2011
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