Provider Demographics
NPI:1033530134
Name:MS HMA DME LLC
Entity Type:Organization
Organization Name:MS HMA DME LLC
Other - Org Name:MCNAMED HOME MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CUSTOMER SERVICE SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:P
Authorized Official - Last Name:PATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-932-8880
Mailing Address - Street 1:4290 LAKELAND DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-9571
Mailing Address - Country:US
Mailing Address - Phone:601-932-8880
Mailing Address - Fax:601-932-7656
Practice Address - Street 1:4290 LAKELAND DR
Practice Address - Street 2:SUITE B
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-9571
Practice Address - Country:US
Practice Address - Phone:601-932-8880
Practice Address - Fax:601-932-7656
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MS HMA LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-12-17
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS1891080289Medicare PIN