Heritage South Medical Services, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

HERITAGE SOUTH MEDICAL SERVICES, LLC

Practice address

201 W Sunflower Rd
Cleveland, MS 38732-2637

Phone

(662) 843-0142

Fax

(662) 846-7659

NPI assigned

Oct 6, 2006

Last updated

Jul 29, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Charline Brandon

Title

Owner

Phone

(662) 843-0142

Specialties & licenses 1

Addresses

Other identifiers 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280361600000",
    "number": "1033206206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1449",
            "city": "CLEVELAND",
            "state": "MS",
            "postal_code": "387321449",
            "telephone_number": "662-843-0142",
            "fax_number": "662-846-7659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W SUNFLOWER RD",
            "city": "CLEVELAND",
            "state": "MS",
            "postal_code": "387322637",
            "telephone_number": "662-843-0142",
            "fax_number": "662-846-7659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE SOUTH MEDICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2010-07-29",
        "status": "A",
        "authorized_official_last_name": "BRANDON",
        "authorized_official_first_name": "CHARLINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-843-0142"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05527908",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "450500088",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• David I Hirsch, M.D.
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• Durable Medical Equipment & Medical Supplies in Cleveland, MS
• Providers in Cleveland, MS by specialty
• Durable Medical Equipment & Medical Supplies in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.