Provider Demographics
NPI:1891952636
Name:SOUTHWIND MEDICAL SUPPLIES LLC
Entity Type:Organization
Organization Name:SOUTHWIND MEDICAL SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-716-8198
Mailing Address - Street 1:5001 COLLEGE BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1618
Mailing Address - Country:US
Mailing Address - Phone:816-716-8198
Mailing Address - Fax:913-273-1470
Practice Address - Street 1:6600 COLLEGE BLVD STE 100A
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1876
Practice Address - Country:US
Practice Address - Phone:913-647-6633
Practice Address - Fax:913-647-6635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies