Provider Demographics
NPI:1972660322
Name:OLIVER INSTRUMENT COMPANY
Entity Type:Organization
Organization Name:OLIVER INSTRUMENT COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ASHTON
Authorized Official - Middle Name:
Authorized Official - Last Name:SUMMERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-981-2564
Mailing Address - Street 1:630 HIGHWAY 49 STE B
Mailing Address - Street 2:
Mailing Address - City:FLORA
Mailing Address - State:MS
Mailing Address - Zip Code:39071-9731
Mailing Address - Country:US
Mailing Address - Phone:601-981-2564
Mailing Address - Fax:601-981-2565
Practice Address - Street 1:630 HIGHWAY 49 STE B
Practice Address - Street 2:
Practice Address - City:FLORA
Practice Address - State:MS
Practice Address - Zip Code:39071-9731
Practice Address - Country:US
Practice Address - Phone:601-981-2564
Practice Address - Fax:601-981-2565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS200002727Medicaid
MS00040085Medicaid