Provider Demographics
NPI:1275976854
Name:SPECIALTY MEDICAL AND EQUIPMENT LLC
Entity Type:Organization
Organization Name:SPECIALTY MEDICAL AND EQUIPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FELIX
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:RODRIGUE
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:228-806-7095
Mailing Address - Street 1:13713 MESA RD
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-2559
Mailing Address - Country:US
Mailing Address - Phone:228-806-7095
Mailing Address - Fax:
Practice Address - Street 1:1009 BYRD DR
Practice Address - Street 2:
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-3018
Practice Address - Country:US
Practice Address - Phone:228-806-7095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-12
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSF12229332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies