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Organization

EXECUTIVE MEDICAL SUPPLIES LLC

Active
Parent organization
EXECUTIVE MEDICAL SUPPLIES LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
EXECUTIVE MEDICAL SUPPLIES LLC
Authorized official
MILO COLLINS (OWNER)
(601) 469-9040
Entity
Organization

Contact information

Practice address
209 N FIR AVE, COLLINS, MS 39428-9998
(601) 469-9040
Mailing address
135 E THIRD ST, FOREST, MS 39074-4101
(601) 469-9040
(601) 469-9040

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0888/11.1
MS

Other

Enumeration date
11/12/2014
Last updated
11/12/2014
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