Organization
MEDICAL SUPPLY DME LLC
Active
Organization
MEDICAL SUPPLY DME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ETTA STARKS (OWNER)
(470) 865-2445
Entity
Organization
Contact information
Practice address
2400 PROMENADE BLVD APT 2, MONTGOMERY, AL 36106-4001
(470) 865-2445
Mailing address
2400 PROMENADE BLVD APT 2, MONTGOMERY, AL 36106-4001
(470) 865-2445
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
332BN1400X
Nursing Facility Supplies (DME)
—
—
Other
Enumeration date
02/20/2019
Last updated
03/01/2019
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