Provider Demographics
NPI:1376860312
Name:ANCILLARY MANAGEMENT SERVICES, INC.
Entity Type:Organization
Organization Name:ANCILLARY MANAGEMENT SERVICES, INC.
Other - Org Name:CHOCTAW MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-693-2484
Mailing Address - Street 1:1500 ROEBUCK DR
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39301-6628
Mailing Address - Country:US
Mailing Address - Phone:601-693-2484
Mailing Address - Fax:601-485-8110
Practice Address - Street 1:303 S HAMBURG AVE
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:AL
Practice Address - Zip Code:36904-2515
Practice Address - Country:US
Practice Address - Phone:601-693-2484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANCILLARY MANAGEMENT SERVICES INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-04-30
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies