SOUTHEASTERN MEDICAL SUPPLY (NPI# 1700034162) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700034162 |
| Entity Type | Organization |
| Organization Name | SOUTHEASTERN MEDICAL SUPPLY |
| Practice Address |
1010 19th Ave Suite 1 Meridian MS 39301-5227 |
| Practice Telephone | 6018460169 |
| Mailing Telephone | 6018460169 |
| Enumeration Date | 2008-08-28 |
| Last Update Date | 2008-10-01 |
| Authorized Official Name | MS. MARY ANGELA HARRIS (OWNER) |
| Authorized Official Telephone | 6018460169 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332BD1200X |
Durable Medical Equipment & Medical Supplies Specialization: Dialysis Equipment & Supplies |
Suppliers | ||
| N | 332BX2000X |
Durable Medical Equipment & Medical Supplies Specialization: Oxygen Equipment & Supplies |
Suppliers | ||
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SOUTHEASTERN MEDICAL SUPPLY | 2711 Alpine Rd Ste 210, Columbia, SC 29223-1114 |
| Street Address |
1010 19TH AVE SUITE 1 |
| City | MERIDIAN |
| State | MS |
| Zip Code | 39301-5227 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295026763 | Advanced Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 1010 19th Ave, Meridian, MS 39301-5227 | 2011-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407460439 | Kayla Lee Monsour | Pharmacist | 1415 24th Avenue, Meridian, MS 39301 | 2020-09-08 |
| 1306478359 | K&r Optical Solutions Corporation | Eyewear Supplier (Equipment, not the service) | 3126 8th St., Suite A, Meridian, MS 39301 | 2020-02-07 |
| 1912537317 | Courtney M Hollie | Counselor | 1054 Ms-19, Meridian, MS 39301 | 2020-01-24 |
| 1932636495 | Rcg Mississippi, Inc. | Clinic/Center | 1300 38th Ave E, Meridian, MS 39301 | 2017-05-16 |
| 1811428915 | Tierria Mcglothin | Nurse Practitioner | 1054 Highway 19 S, Meridian, MS 39301 | 2017-03-21 |
| 1154869303 | Lindsay Nemanich | Physical Therapist | 3716 Ms-39, Meridian, MS 39301 | 2017-02-08 |
| 1700323599 | Wal-mart Stores East Lp | Pharmacy | 3310-a Highway 39 North, Meridian, MS 39301 | 2017-01-31 |
| 1972977460 | Southeast Pharmacy LLC | Pharmacy | 2402 Long Creek Road, Meridian, MS 39301 | 2015-11-20 |
| 1235508342 | East Mississippi Oral & Facial Surgery, LLC | Clinic/Center | 1212 24th Avenue, Meridian, MS 39301 | 2015-09-18 |
| 1831580778 | Clarkdale Pharmacy and Gifts LLC | Pharmacy | 6935c Hwy 145, Meridian, MS 39301 | 2015-02-13 |
| Find all providers in zip 39301 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801387634 | Stallones Mobility LLC | Durable Medical Equipment & Medical Supplies | 943 W Overland Rd, Meridian, ID 83642-6541 | 2018-05-29 |
| 1265982920 | Thrifty Payless Inc | Durable Medical Equipment & Medical Supplies | 3250 S Eagle Rd, Meridian, ID 83642-7018 | 2016-10-06 |
| 1538587290 | Health1logistics | Durable Medical Equipment & Medical Supplies | 2949 E Copper Point Dr, Suite 125, Meridian, ID 83642-5016 | 2014-03-31 |
| 1821339136 | Mommy's Own | Durable Medical Equipment & Medical Supplies | 1107 E Pisa St, Meridian, ID 83642-7888 | 2013-03-12 |
| 1316287998 | Sams East Inc | Durable Medical Equipment & Medical Supplies | 715 Bonita Dr, Meridian, MS 39301-4603 | 2013-02-19 |
| 1720327265 | Redtail Supply Corporation Dba Amramp | Durable Medical Equipment & Medical Supplies | 2375 S Cobalt Point Way Ste 102, Meridian, ID 83642-8029 | 2013-02-04 |
| 1780958421 | Medselect LLC | Durable Medical Equipment & Medical Supplies | 721 Front Street Ext Ste 732, Meridian, MS 39301-4586 | 2012-02-27 |
| 1497022420 | Great Western Distribution of Idaho, LLC | Durable Medical Equipment & Medical Supplies | 480 E Franklin Rd, Suite 108, Meridian, ID 83642-2919 | 2011-11-18 |
| 1215231311 | Prairie Enterprises LLC | Durable Medical Equipment & Medical Supplies | 3332 N Boulder Creek Ave, Meridian, ID 83646-5553 | 2011-01-04 |
| 1811205842 | Royal Innovations,llc | Durable Medical Equipment & Medical Supplies | 3796 E Presidential Dr, Meridian, ID 83642-6035 | 2010-09-24 |
| Find all providers in MERIDIAN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.