Provider Demographics
NPI:1740559921
Name:MISSISSIPPI HMA DME, LLC
Entity Type:Organization
Organization Name:MISSISSIPPI HMA DME, LLC
Other - Org Name:CAREPLUS HOME MEDICAL BILOXI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR VP AND GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:PARRY
Authorized Official - Suffix:
Authorized Official - Credentials:ESQ
Authorized Official - Phone:239-552-3458
Mailing Address - Street 1:4290 LAKELAND DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-9571
Mailing Address - Country:US
Mailing Address - Phone:228-435-8370
Mailing Address - Fax:228-435-8374
Practice Address - Street 1:184 MAIN ST
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39530-3808
Practice Address - Country:US
Practice Address - Phone:228-435-8370
Practice Address - Fax:228-435-8374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-19
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00440485Medicaid
MS00440485Medicaid