Organization
OUTREACH MEDICAL SUPPLIES,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMMANUEL EKON SR. (PRESIDENT)
(423) 313-0778
Entity
Organization
Contact information
Practice address
3783 GEORGETOWN RD NW, SUITE 3, CLEVELAND, TN 37312-2579
(423) 313-0778
(423) 553-5592
Mailing address
3783 GEORGETOWN RD NW, SUITE 3, CLEVELAND, TN 37312-2579
(423) 313-0778
(423) 553-5592
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
00000781
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1455232
—
TN
01
—
4163299
BCBSTN
—
Enumeration date
03/01/2007
Last updated
03/18/2008
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