Provider Demographics
NPI:1851595672
Name:HEALTH CARE MEDICAL
Entity Type:Organization
Organization Name:HEALTH CARE MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:TOLLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-420-0064
Mailing Address - Street 1:371 TOWNE CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-4833
Mailing Address - Country:US
Mailing Address - Phone:601-420-0064
Mailing Address - Fax:601-420-0223
Practice Address - Street 1:371 TOWNE CENTER BLVD
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-4833
Practice Address - Country:US
Practice Address - Phone:601-420-0064
Practice Address - Fax:601-420-0223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS05864 11.1332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies