Provider Demographics
NPI:1629249552
Name:SOUTHERN PATIENT CARE, INC.
Entity Type:Organization
Organization Name:SOUTHERN PATIENT CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TONI
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-776-8323
Mailing Address - Street 1:120 W PARK DR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35211-4469
Mailing Address - Country:US
Mailing Address - Phone:205-776-8323
Mailing Address - Fax:205-776-8329
Practice Address - Street 1:721 HARRIS ST STE AAA
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39202-3462
Practice Address - Country:US
Practice Address - Phone:888-880-4772
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2019-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies