| Organization Name: | MED-MART HOME CARE INC |
| NPI Number: | 1144228412 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KENNEY BLEASE BUTLER (CO-OWNER) |
| Mailing Address: | 225 Maggie Dr Pontotoc |
| State: | MS US |
| Postal Code: | 388638631 |
| Phone Number: | 6624899330 |
| Fax Number: | 6624899363 |
| NPI Enumeration Date: | 07/12/2005 |
| NPI Last Update Date: | 09/27/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BX2000X |
| License Number: | 1132590001 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MS |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Oxygen Equipment & Supplies |
| Taxonomy Definition: | |