Provider Demographics
NPI:1093019432
Name:JEFFREY CARTER ENTERPRICES, LLC.
Entity Type:Organization
Organization Name:JEFFREY CARTER ENTERPRICES, LLC.
Other - Org Name:MID SOUTH DIABETIC AND MEDICAL SUPPLIES, LLC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-327-4620
Mailing Address - Street 1:PO BOX 8774
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39705-0013
Mailing Address - Country:US
Mailing Address - Phone:662-327-4620
Mailing Address - Fax:662-241-5900
Practice Address - Street 1:1809 7TH AVE N
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39701-4844
Practice Address - Country:US
Practice Address - Phone:662-327-4620
Practice Address - Fax:662-327-4620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-28
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies