Provider Demographics
NPI:1649280165
Name:SAAD MEDICAL EQUIPMENT, INC.
Entity type:Organization
Organization Name:SAAD MEDICAL EQUIPMENT, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:B
Authorized Official - Last Name:FULGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-343-9600
Mailing Address - Street 1:10598 DIBERVILLE BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:DIBERVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39540-2465
Mailing Address - Country:US
Mailing Address - Phone:228-432-5622
Mailing Address - Fax:228-432-0010
Practice Address - Street 1:10598 DIBERVILLE BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:DIBERVILLE
Practice Address - State:MS
Practice Address - Zip Code:39540-2465
Practice Address - Country:US
Practice Address - Phone:228-432-5622
Practice Address - Fax:228-432-0010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS03506/11.1332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS000012326OtherBLUE CROSS BLUE SHIELD
MS00040073Medicaid
MS00040073Medicaid