Provider Demographics
NPI:1003214198
Name:COOK WHOLESALE CO INC
Entity Type:Organization
Organization Name:COOK WHOLESALE CO INC
Other - Org Name:COOK MEDICAL SUPPLY CARTHAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-732-6334
Mailing Address - Street 1:404 HIGHWAY 16 E
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:MS
Mailing Address - Zip Code:39051-4208
Mailing Address - Country:US
Mailing Address - Phone:601-267-6334
Mailing Address - Fax:601-267-6334
Practice Address - Street 1:404 HIGHWAY 16 E
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:MS
Practice Address - Zip Code:39051-4208
Practice Address - Country:US
Practice Address - Phone:601-267-6334
Practice Address - Fax:601-267-6334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-05
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS0860870002Medicare NSC