NPIMap

Organization Active NPI

Executive Medical Supplies LLC

  • Durable Medical Equipment & Medical Supplies
  • Forest, MS
National Provider Identifier
1124312400
Registry record updated Aug 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
981193 Issued in MS
Legal business name
EXECUTIVE MEDICAL SUPPLIES LLC
Practice address
135 E Third St
Forest, MS 39074-4101
Phone
(601) 469-9040
NPI assigned
Jun 4, 2011
Last updated
Aug 23, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2013

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

Authorized official

Name
Milo D Collins
Title
Owner
Phone
(769) 798-9799

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 981193 MS Primary

Addresses

Primary practice location

135 E Third St
Forest, MS 39074-4101

Mailing address

135 E Third St
Forest, MS 39074-4101
Phone (601) 469-9040

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1307145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377216000000",
    "number": "1124312400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 E THIRD ST",
            "city": "FOREST",
            "state": "MS",
            "postal_code": "390744101",
            "telephone_number": "601-469-9040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 E THIRD ST",
            "city": "FOREST",
            "state": "MS",
            "postal_code": "390744101",
            "telephone_number": "601-469-9040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXECUTIVE MEDICAL SUPPLIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-04",
        "last_updated": "2013-08-23",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "MILO",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "769-798-9799"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MS",
            "license": "981193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2013; 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.