Organization
OUTREACH MEDICAL SUPPLIES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMMANUEL EKON SR. (PRESIDENT)
(423) 553-5595
Entity
Organization
Contact information
Practice address
515 AIRPORT RD, STE 114, CHATTANOOGA, TN 37421-3583
(423) 553-5595
(423) 553-5592
Mailing address
515 AIRPORT RD, STE 114, CHATTANOOGA, TN 37421-3583
(423) 553-5595
(423) 553-5592
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1454459
—
TN
01
—
4083579
BCBSTN
—
Enumeration date
06/22/2005
Last updated
03/18/2008
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