Provider Demographics
NPI:1609959329
Name:NORFOLK SUPPLY
Entity Type:Organization
Organization Name:NORFOLK SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NED
Authorized Official - Middle Name:O
Authorized Official - Last Name:KRONFOL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:662-335-4105
Mailing Address - Street 1:PO BOX 6000
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38704-6000
Mailing Address - Country:US
Mailing Address - Phone:662-335-4105
Mailing Address - Fax:662-378-2879
Practice Address - Street 1:1409 E UNION ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:MS
Practice Address - Zip Code:38703-3247
Practice Address - Country:US
Practice Address - Phone:662-335-4105
Practice Address - Fax:662-378-2879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BD1200XSuppliersDurable Medical Equipment & Medical SuppliesDialysis Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS0440888Medicaid
1056260001Medicare NSC