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Organization

PROFESSIONAL MEDICAL SUPPLY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
FREDDY C MULLINS RRT (MGR OWNER)
(606) 451-0216
Entity
Organization

Contact information

Practice address
342 BOGLE ST, STE 1, SOMERSET, KY 42503-2851
(606) 451-0216
(606) 451-1959
Mailing address
342 BOGLE ST, STE 1, SOMERSET, KY 42503-2851
(606) 451-0216
(606) 451-1959

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
182153
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
90013822
KY
Enumeration date
07/07/2005
Last updated
04/10/2012
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