Medical Depot LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MEDICAL DEPOT LLC

Practice address

4969 Highway 28
Mize, MS 39116-5355

Phone

(601) 480-6509

NPI assigned

Jun 27, 2016

Last updated

Jun 27, 2016By 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

Jerry R. Rayner

Title

Owner

Phone

(601) 480-6509

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1466985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466985600000",
    "number": "1609227123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4969 HWY 28",
            "city": "MIZE",
            "state": "MS",
            "postal_code": "39116",
            "telephone_number": "601-480-6509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4969 HIGHWAY 28",
            "city": "MIZE",
            "state": "MS",
            "postal_code": "391165355",
            "telephone_number": "601-480-6509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL DEPOT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-27",
        "last_updated": "2016-06-27",
        "status": "A",
        "authorized_official_last_name": "RAYNER",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-480-6509"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family Health Care Clinic, Inc.
• Charity Darlene Hohm-Whaley
• Magee Benevolent Association (Mize Healthcare Center)
• Mize Family Medicine LLC
• Marsha Ann Tanner, MT(AMT)

• Durable Medical Equipment & Medical Supplies in Mize, MS
• Providers in Mize, 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 Jun 27, 2016; 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.