Organization
J. J. HILL BRACE AND LIMB CO., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAWRENCE ALLEN HILL C.P., BOCOP, C. PED (PRESIDENT)
(228) 863-0381
Entity
Organization
Contact information
Practice address
1619 BROAD AVE, GULFPORT, MS 39501-3604
(228) 863-0381
(228) 863-2784
Mailing address
1619 BROAD AVE, GULFPORT, MS 39501-3604
(228) 863-0381
(228) 863-2784
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BC3200X
Customized Equipment (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000011708
BLUE CROSS BLUE SHIELD
MS
05
—
00040510
—
MS
01
—
16865400
US DEPARTMENT OF LABOR
MS
Enumeration date
10/25/2006
Last updated
06/29/2010
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