Organization
DEEP SOUTH MEDICAL SUPPLY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN BANNISTER (MANAGER)
(318) 927-3523
Entity
Organization
Contact information
Practice address
311 CHISUM ST, SICILY ISLAND, LA 71368-4807
(318) 389-5807
Mailing address
PO BOX 38, SICILY ISLAND, LA 71368-0038
(318) 389-5807
(318) 389-5842
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2207385
—
LA
Enumeration date
03/20/2019
Last updated
12/07/2020
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up