Shatessie Marie Ford, CRT
Individual provider Active NPI Durable Medical Equipment & Medical Supplies · Okolona, MS
NPI 1487053740 · NPPES record last updated Oct 8, 2014
Key facts
- NPI
- 1487053740
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Durable Medical Equipment & Medical Supplies 332B00000X
- License
- 200003542 (MS)
- Practice address
- 211 E Main St
Okolona, MS 38860-1529 - Phone
- (662) 322-0340
- NPI assigned
- Aug 21, 2014
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200003542 | MS | MD | Durable Medical Equipment & Medical Supplies |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 200003542 | MS | Yes |
Addresses
Primary practice location
211 E Main St
Okolona, MS 38860-1529
Mailing address
308 S Gatlin St
Okolona, MS 38860-2005
Phone (662) 322-0340
Other providers in Okolona, MS
- Michael Bullock
- Sarah Carollo
- Joy S Chapman
- Chickasaw FMC
- Family Medical Clinic of Okolona
- Harley'S Home Care
- Heavenly Angels Community Living, Inc.
- Whitley Breanna Hill
- Hodges Adult Day Care Service Inc
- Hometown Care of North Mississippi, Inc
All providers in Okolona, MS · Durable Medical Equipment & Medical Supplies in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 8, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.