Organization
CENTRAL MISSISSIPPI MEDICAL EQUIPMENT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY BROOKINS (PRESIDENT)
(601) 982-4085
Entity
Organization
Contact information
Practice address
5538 N. STATE STREET, SUITE 104, JACKSON, MS 39206
(601) 982-4085
Mailing address
5538 N. STATE STREET, SUITE 104, JACKSON, MS 39206
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
06336 / 11.1
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04109551
—
MS
Enumeration date
10/03/2006
Last updated
10/19/2009
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