Organization Name: | INNOVATIVE PROSTHETIC CARE TUPELO LLC |
NPI Number: | 1033499744 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SHERYL S PRICE (DIRECTOR OF REIMBURSEMENT) |
Mailing Address: | 1714 N Gloster St Tupelo |
State: | MS US |
Postal Code: | 388041216 |
Phone Number: | 6628442202 |
Fax Number: | 6015101610 |
NPI Enumeration Date: | 08/25/2011 |
NPI Last Update Date: | 02/21/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |