| Organization Name: | PROFESSIONAL MEDICAL SUPPLY LLC |
| NPI Number: | 1932106663 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | FREDDY C MULLINS (MGR OWNER) |
| Mailing Address: | 342 Bogle St Ste 1 Somerset |
| State: | KY US |
| Postal Code: | 425032851 |
| Phone Number: | 6064510216 |
| Fax Number: | 6064511959 |
| NPI Enumeration Date: | 07/07/2005 |
| NPI Last Update Date: | 04/10/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | 182153 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| 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 |