Organization
ROBERT LEE MCLEROY
Active
Other names
Diabetic Store and More
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DAWN WALDROP CFT (SECRETARY)
(662) 838-4500
Entity
Organization
Contact information
Practice address
28 CHASE ST, BYHALIA, MS 38611-7363
(662) 838-4500
(662) 838-4502
Mailing address
28 CHASE ST, BYHALIA, MS 38611-7363
(662) 838-4500
(662) 838-4502
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1234
APPLIED
—
Enumeration date
05/16/2012
Last updated
05/16/2012
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