Provider Demographics
NPI:1770655136
Name:SAL-LIZ INC
Entity Type:Organization
Organization Name:SAL-LIZ INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER FOR SAL-LIZ LINGERIE
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANCISKATO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-932-0179
Mailing Address - Street 1:1000 LAKELAND SQUARE
Mailing Address - Street 2:
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232
Mailing Address - Country:US
Mailing Address - Phone:601-932-0179
Mailing Address - Fax:601-932-6235
Practice Address - Street 1:1000 LAKELAND SQUARE
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232
Practice Address - Country:US
Practice Address - Phone:601-932-0179
Practice Address - Fax:601-932-6235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS0568680001Medicare ID - Type Unspecified