Provider Demographics
NPI:1508376559
Name:NEW HOPE MEDICAL SUPPLY LLC
Entity Type:Organization
Organization Name:NEW HOPE MEDICAL SUPPLY LLC
Other - Org Name:NEW HOPE MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:HOGG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-413-2500
Mailing Address - Street 1:1321 W MAUD ST
Mailing Address - Street 2:
Mailing Address - City:POPLAR BLUFF
Mailing Address - State:MO
Mailing Address - Zip Code:63901-4819
Mailing Address - Country:US
Mailing Address - Phone:573-413-2500
Mailing Address - Fax:
Practice Address - Street 1:1710 W HARPER ST
Practice Address - Street 2:
Practice Address - City:POPLAR BLUFF
Practice Address - State:MO
Practice Address - Zip Code:63901-4121
Practice Address - Country:US
Practice Address - Phone:573-413-2500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-04
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies