Organization
SIMPSON COUNTY MEDICAL SUPPLY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SARA KENNEDY (MEMBER/MANAGER)
(601) 849-9182
Entity
Organization
Contact information
Practice address
200 2ND AVE SE, MAGEE, MS 39111-3605
(601) 849-9182
(601) 849-5781
Mailing address
200 2ND AVE SE, MAGEE, MS 39111-3605
(601) 849-9182
(601) 849-5781
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
07135/11.1
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05080373
—
MS
Enumeration date
10/23/2006
Last updated
03/05/2015
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