Organization
TARGET MEDICAL INC, MS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS R BROCKWAY SR. (PRESIDENT)
(901) 323-1304
Entity
Organization
Contact information
Practice address
7065 AIRWAYS BLVD STE 104, SOUTHAVEN, MS 38671-5873
(662) 349-1394
(662) 349-1394
Mailing address
7065 AIRWAYS BLVD STE 104, SOUTHAVEN, MS 38671-5873
(662) 349-1394
(662) 349-1394
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
08/10/2011
Last updated
10/19/2011
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