Mississippi Medical Supply, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MISSISSIPPI MEDICAL SUPPLY, LLC

Doing business as

Mid South Medical & Mobility

Practice address

568 Highway 51 S
Batesville, MS 38606-2547

Phone

(662) 563-8200

Fax

(662) 563-8600

NPI assigned

May 19, 2006

Last updated

Sep 23, 2008By 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

Mr. David Lee Bowman

Title

Chief Manager

Phone

(901) 507-2561

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mid South Medical & Mobility Doing business as

Locations

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222128000000",
    "number": "1295789816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2597",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380882597",
            "telephone_number": "901-507-2561",
            "fax_number": "901-339-3274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "568 HIGHWAY 51 S",
            "city": "BATESVILLE",
            "state": "MS",
            "postal_code": "386062547",
            "telephone_number": "662-563-8200",
            "fax_number": "662-563-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSISSIPPI MEDICAL SUPPLY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2008-09-23",
        "status": "A",
        "authorized_official_last_name": "BOWMAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CHIEF MANAGER",
        "authorized_official_telephone_number": "901-507-2561",
        "authorized_official_name_prefix": "Mr."
    },
    "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": "0440528",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mid South Medical & Mobility",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Mississippi State Department of Health
• Colleen Montgomery
• Natalie Herrington Moore, CFNP
• Timothy Moore
• Crystie Sheree Moorman, PHARMD

• Durable Medical Equipment & Medical Supplies in Batesville, MS
• Providers in Batesville, 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 Sep 23, 2008; 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.