Organization Name: | SOUTHERN EXPRESS MEDICAL SUPPLY, INC |
NPI Number: | 1265431928 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL BRUCE (OWNER) |
Mailing Address: | 125 Church St Suite B Georgiana |
State: | AL US |
Postal Code: | 36033 |
Phone Number: | 3343760003 |
Fax Number: | 3343765777 |
NPI Enumeration Date: | 07/15/2005 |
NPI Last Update Date: | 10/12/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332BP3500X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | Parenteral & Enteral Nutrition |
Taxonomy Definition: |