| Organization Name: | LAUREL ADVANCED MEDICAL EQUIPMENT |
| NPI Number: | 1477980811 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TRACY DEWAIN WILSON (OWNER) |
| Mailing Address: | 1003 Mitchell Dr Laurel |
| State: | MS US |
| Postal Code: | 394402548 |
| Phone Number: | 6014262178 |
| Fax Number: | 6014262179 |
| NPI Enumeration Date: | 09/30/2013 |
| NPI Last Update Date: | 01/21/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | 12649/11.1 |
| 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 |