Provider Demographics
NPI:1578865630
Name:WOOD MEDICAL SUPPORT INC
Entity Type:Organization
Organization Name:WOOD MEDICAL SUPPORT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:N
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-801-8519
Mailing Address - Street 1:PO BOX 1479
Mailing Address - Street 2:128A COURTHOUSE SQUARE
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-1479
Mailing Address - Country:US
Mailing Address - Phone:662-801-8519
Mailing Address - Fax:662-236-9892
Practice Address - Street 1:128A COURTHOUSE SQ
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-4008
Practice Address - Country:US
Practice Address - Phone:662-801-8519
Practice Address - Fax:662-236-9892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-23
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN093004356332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies