Organization
DMED
Active
Other names
DMED
Organization subpart
No
Provider details
NPI number
Authorized official
MS. EDITH MELISSA CORKERN RN (VICE PRESIDENT)
(601) 573-0386
Entity
Organization
Contact information
Practice address
558 HIGHWAY 6 E, SUITE B, BATESVILLE, MS 38606-3002
(662) 934-1076
(662) 563-0155
Mailing address
PO BOX 55671, JACKSON, MS 39296-5671
(601) 573-0386
(601) 856-8003
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03720722
—
MS
Enumeration date
07/10/2006
Last updated
08/22/2020
Update your record
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