Provider Demographics
NPI:1356488803
Name:MED LINK AMERICA, INC.
Entity Type:Organization
Organization Name:MED LINK AMERICA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:H
Authorized Official - Last Name:MASSEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:504-832-4959
Mailing Address - Street 1:PO BOX 58079
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70158-8079
Mailing Address - Country:US
Mailing Address - Phone:504-832-4959
Mailing Address - Fax:800-659-8283
Practice Address - Street 1:2318 E PASS RD STE F
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39507-3805
Practice Address - Country:US
Practice Address - Phone:800-669-0456
Practice Address - Fax:800-659-8283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3403-IR332B00000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
1118900001Medicare NSC