Great South Medical Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

0000000507 Issued in TN

Legal business name

GREAT SOUTH MEDICAL INC.

Practice address

382 Carriage House Dr Ste a
Jackson, TN 38305-2299

Phone

(731) 664-8716

Fax

(731) 664-8932

NPI assigned

Apr 13, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Jay F Louviere

Title

Owner

Phone

(731) 664-8874

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338854400000",
    "number": "1871557397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "382 CARRIAGE HOUSE DR STE A",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052299",
            "telephone_number": "731-664-8716",
            "fax_number": "731-664-8932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "382 CARRIAGE HOUSE DR STE A",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052299",
            "telephone_number": "731-664-8716",
            "fax_number": "731-664-8932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT SOUTH MEDICAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-13",
        "last_updated": "2012-06-05",
        "status": "A",
        "authorized_official_last_name": "LOUVIERE",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "731-664-8874",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TN",
            "license": "0000000507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TN",
            "identifier": "0183977",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS LA",
            "identifier": "B1203",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kevin G Gray, M.D.
• Riley Renay Gray
• Shannon A Gray, CASE MANAGER
• Wesli Shane Gray, CASE MANAGER
• Debra M Grear, CASE MANAGER
• Deidre Green, MSW
• Diane Elaine Green, MD
• Euniquica Tanette Green
• Kelly D Green, M.D.
• Richard Earl Green Jr., MD

• Durable Medical Equipment & Medical Supplies in Jackson, TN
• Providers in Jackson, TN by specialty
• Durable Medical Equipment & Medical Supplies in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2012; 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.