Organization
AVAILABLE PHARMACEUTICAL SERVICES
Active
Other names
southern respiratory services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JIM R KELLY (OWNER CEO)
(601) 782-9943
Entity
Organization
Contact information
Practice address
205 MAIN ST N STE C, MENDENHALL, MS 39114-3444
(601) 847-7370
(601) 847-4709
Mailing address
PO BOX 296, RALEIGH, MS 39153-0296
(601) 847-7370
(601) 847-4709
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
06453 11.1
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0440265
—
MS
Enumeration date
12/15/2006
Last updated
08/29/2007
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