Provider Demographics
NPI:1568673655
Name:AMERICAN MEDICAL SUPPLY
Entity Type:Organization
Organization Name:AMERICAN MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANIS
Authorized Official - Middle Name:K
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:228-863-8974
Mailing Address - Street 1:8010 HWY 49N 112B
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39501
Mailing Address - Country:US
Mailing Address - Phone:228-863-8974
Mailing Address - Fax:228-863-8975
Practice Address - Street 1:8010 HIGHWAY 49 APT 112B
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39501-7010
Practice Address - Country:US
Practice Address - Phone:228-863-8974
Practice Address - Fax:228-863-8975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BD1200XSuppliersDurable Medical Equipment & Medical SuppliesDialysis Equipment & Supplies