Organization
TECH MED SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONNIE GROGAN RT (PRESIDENT / OWNER)
(601) 932-0673
Entity
Organization
Contact information
Practice address
3900 LAKELAND DR, SUITE 300, FLOWOOD, MS 39232-8852
(601) 932-0673
(601) 420-5299
Mailing address
PO BOX 636, CLINTON, MS 39060-0636
(601) 932-0673
(601) 420-5299
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
06345/11.1
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02971738
—
MS
Enumeration date
06/16/2006
Last updated
01/28/2010
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