Organization
SANDERS VITAL CARE INC
Active
Other names
Sanders Vital Care
Organization subpart
No
Provider details
NPI number
Authorized official
WYNN SANDERS (PRESIDENT)
(662) 378-2060
Entity
Organization
Contact information
Practice address
1427 S MAIN ST, GREENVILLE, MS 38701-7000
(662) 378-2060
(662) 332-9966
Mailing address
1427 S MAIN ST, GREENVILLE, MS 38701-7000
(662) 378-2060
(662) 332-9966
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
01568011
MS
332BC3200X
Customized Equipment (DME)
01568011
MS
332BN1400X
Nursing Facility Supplies (DME)
01568011
MS
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
01568011
MS
332BX2000X
Oxygen Equipment & Supplies (DME)
01568011
MS
333600000X
Pharmacy
01568011
MS
3336C0003X
Community/Retail Pharmacy
01568011
MS
3336H0001X
Home Infusion Therapy Pharmacy
01568011
MS
3336I0012X
Institutional Pharmacy
01568011
MS
3336L0003X
Long Term Care Pharmacy
01568011
MS
3336M0002X
Mail Order Pharmacy
01568011
MS
3336S0011X
Specialty Pharmacy
01568011
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00040008
—
MS
Enumeration date
07/10/2006
Last updated
01/31/2011
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