Organization
SOUTHEASTERN MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY ANGELA HARRIS (OWNER)
(601) 846-0169
Entity
Organization
Contact information
Practice address
1010 19TH AVE, SUITE 1, MERIDIAN, MS 39301-5227
(601) 846-0169
Mailing address
1010 19TH AVE, SUITE 1, MERIDIAN, MS 39301-5227
(601) 846-0169
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BD1200X
Dialysis Equipment & Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
Other
Enumeration date
08/28/2008
Last updated
10/01/2008
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