Organization Name: | PATRICK E IGBOKWE |
NPI Number: | 1619268810 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PATRICK E IGBOKWE (OWNER/SOLE MEMBER) |
Mailing Address: | 4798 Highway 61 S Suite B Vicksburg |
State: | MS US |
Postal Code: | 391807125 |
Phone Number: | 6016309300 |
Fax Number: | 6016300133 |
NPI Enumeration Date: | 04/22/2011 |
NPI Last Update Date: | 06/27/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 07659/11.1 |
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 |