Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Nursing Facility Supplies |
332BN1400X | 87 | All Other Suppliers |
| NPI Number | 1619028917 |
| LBN Legal business name | SOUTH SHREVE MEDICAL SUPPLIES, INC. |
| Authorized official | CHARLES MACEY - (CONTROLLER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 01/15/2007 |
| Last updated | 08/22/2020 - About 6 years ago |
| Identifiers | n/a |
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