Organization Active NPI

Southern Sickroom Supply

  • Durable Medical Equipment & Medical Supplies
  • Columbus, MS
National Provider Identifier
1093741050
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
SOUTHERN SICKROOM SUPPLY
Practice address
1202 Main St
Columbus, MS 39701-5833
Phone
(662) 328-0847
NPI assigned
Jun 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. James Gable
Title
President
Phone
(662) 328-0847

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X MS Primary

Addresses

Primary practice location

1202 Main St
Columbus, MS 39701-5833

Mailing address

1202 Main St
Columbus, MS 39701-5833

Other identifiers 1

IdentifierTypeStateIssuer
00040673MedicaidMS

National Provider Directory

National Provider Directory

Locations

1202 Main St
Columbus, MS 39701
Phone (662) 328-0833

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1093741050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 MAIN ST",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397015833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 MAIN ST",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397015833",
            "telephone_number": "662-328-0847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN SICKROOM SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-23",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GABLE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "662-328-0847",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00040673",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.