National Provider Identifier Database

SOUTHERN EXPRESS MEDICAL SUPPLY INC
Parenteral & Enteral Nutrition


Contact Information

SOUTHERN EXPRESS MEDICAL SUPPLY, INC
125 CHURCH ST
SUITE B
GEORGIANA, AL36033
Phone: 334-376-0003
Fax: 334-376-5777
Website:
Specialty Taxonomy Code
* Parenteral & Enteral Nutrition 332BP3500X

* Indicates primary specialty

NPI Profile & details for SOUTHERN EXPRESS MEDICAL SUPPLY, INC

NPI Number 1265431928
Legal business name
LBN
SOUTHERN EXPRESS MEDICAL SUPPLY, INC
Authorized official MICHAEL BRUCE - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 07/15/2005
Last updated 10/12/2015 - About 11 years ago
Sole proprietor1 Not specified
Identifiers
  • AL Medicaid: 000077252
  • AL Other: 51077252 BCBS PROVIDER NUMBER
  • AL Other: 305157 HEALTH INS CORP OF AL

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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