Louisville Medical Supply Inc

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

Legal business name

LOUISVILLE MEDICAL SUPPLY INC

Doing business as

Philadelphia Medical Supply Inc

Practice address

411 Center Ave N
Philadelphia, MS 39350-2920

Phone

(601) 656-0802

Fax

(601) 656-0804

NPI assigned

Oct 7, 2011

Last updated

Oct 7, 2011By the provider in NPPES

Organization subpart

Yes

Parent organization

LOUISVILLE MEDICAL SUPPLY INCAs reported in NPPES

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

Authorized official

Name

Jan P Whitehead

Title

President

Phone

(662) 803-3199

Specialties & licenses 3

Addresses

Other names 1

• PHILADELPHIA MEDICAL SUPPLY INC Doing business as

Part of

Louisville Medical Supply Inc

Locations

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

{
    "created_epoch": "1317945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317945600000",
    "number": "1710261789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 CENTER AVE N",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "393502920",
            "telephone_number": "601-656-0802",
            "fax_number": "601-656-0804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 CENTER AVE N",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "393502920",
            "telephone_number": "601-656-0802",
            "fax_number": "601-656-0804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUISVILLE MEDICAL SUPPLY INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LOUISVILLE MEDICAL SUPPLY INC",
        "enumeration_date": "2011-10-07",
        "last_updated": "2011-10-07",
        "status": "A",
        "authorized_official_last_name": "WHITEHEAD",
        "authorized_official_first_name": "JAN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "662-803-3199"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MS",
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "MS",
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHILADELPHIA MEDICAL SUPPLY INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cameron Gavin Lesley, DPT
• Anna Catherine Lewis, FNP-C
• Line Street Medical Clinic
• Line Street Medical, LLC
• Beth Long
• Jerry Lovorn, MA, LPC.
• Betsy L Mann, FNP
• John E. Mann Jr., M.D.
• Mapp Home Care Services
• Jonathan William Marks, MD

• Oxygen Equipment & Supplies (DME) in Philadelphia, MS
• Providers in Philadelphia, MS by specialty
• Oxygen Equipment & Supplies (DME) in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2011; 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.