Provider Demographics
NPI:1861685414
Name:MEDICAL SUPPLIES INC
Entity Type:Organization
Organization Name:MEDICAL SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:EUBANKS
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:334-886-9111
Mailing Address - Street 1:135 S DALTON ST
Mailing Address - Street 2:P.O. BOX 580
Mailing Address - City:SLOCOMB
Mailing Address - State:AL
Mailing Address - Zip Code:36375-5483
Mailing Address - Country:US
Mailing Address - Phone:334-886-9111
Mailing Address - Fax:334-886-9255
Practice Address - Street 1:135 S DALTON ST
Practice Address - Street 2:
Practice Address - City:SLOCOMB
Practice Address - State:AL
Practice Address - Zip Code:36375-5483
Practice Address - Country:US
Practice Address - Phone:334-886-9111
Practice Address - Fax:334-886-9255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-27
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL129332B00000X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51034246OtherBLUE CROSS BLUE SHIELD
AL1144150001Medicare NSC