Organization
INDIANOLA MEDICAL SOLUTIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TONYA THOMPSON (PRESIDENT)
(662) 207-8598
Entity
Organization
Contact information
Practice address
612 SUNFLOWER AVENUE EXT, BUILDING 1-A, INDIANOLA, MS 38751-2333
(662) 796-0705
(662) 796-1270
Mailing address
612 SUNFLOWER AVENUE EXT, BUILDING 1-A, INDIANOLA, MS 38751-2333
(662) 796-0705
(662) 796-1270
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
Other
Enumeration date
10/28/2007
Last updated
06/25/2008
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