Organization
MED-SOUTH, INC.
Active
Organization
MED-SOUTH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA J. WELLS CPCO (EXECUTIVE DIRECTOR)
(205) 221-8258
Entity
Organization
Contact information
Practice address
345 SAINT LUKES DR, MONTGOMERY, AL 36117-7103
(334) 593-8539
(334) 593-8540
Mailing address
406 MEDICAL CENTER DR, JASPER, AL 35501-3400
(205) 221-8200
(205) 221-8270
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
191
AL
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
900060
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008806210
—
AL
Enumeration date
11/16/2005
Last updated
02/06/2020
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