Organization Name: | EXECUTIVE MEDICAL SUPPLIES LLC |
NPI Number: | 1124312400 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MILO D COLLINS (OWNER) |
Mailing Address: | 135 E Third St Forest |
State: | MS US |
Postal Code: | 390744101 |
Phone Number: | 6014699040 |
Fax Number: | |
NPI Enumeration Date: | 06/04/2011 |
NPI Last Update Date: | 08/23/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 981193 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
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 |