Provider Demographics
NPI:1093795148
Name:MURPHY MEDICAL SUPPLY LLC
Entity Type:Organization
Organization Name:MURPHY MEDICAL SUPPLY LLC
Other - Org Name:TRU-CARE MEDICAL, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-258-2176
Mailing Address - Street 1:P.O. BOX 808
Mailing Address - Street 2:
Mailing Address - City:EUPORA
Mailing Address - State:MS
Mailing Address - Zip Code:39744
Mailing Address - Country:US
Mailing Address - Phone:662-258-2176
Mailing Address - Fax:662-258-3333
Practice Address - Street 1:65 MEDICAL PLAZA
Practice Address - Street 2:
Practice Address - City:EUPORA
Practice Address - State:MS
Practice Address - Zip Code:39744
Practice Address - Country:US
Practice Address - Phone:662-258-2176
Practice Address - Fax:662-258-3333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-17
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS03548332B00000X, 332BX2000X
332B00000X
MS22246332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00440376Medicaid
MS1106650001Medicare NSC