Provider Demographics
NPI:1700073905
Name:AVAILABLE MEDICAL SUPPLIES, INC.
Entity Type:Organization
Organization Name:AVAILABLE MEDICAL SUPPLIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:CARLTON
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-649-4418
Mailing Address - Street 1:PO BOX 128
Mailing Address - Street 2:912 HIGHWAY 15
Mailing Address - City:STRINGER
Mailing Address - State:MS
Mailing Address - Zip Code:39481-0128
Mailing Address - Country:US
Mailing Address - Phone:604-649-4418
Mailing Address - Fax:601-649-4487
Practice Address - Street 1:912 HIGHWAY 15
Practice Address - Street 2:
Practice Address - City:STRINGER
Practice Address - State:MS
Practice Address - Zip Code:39481-4230
Practice Address - Country:US
Practice Address - Phone:604-649-4418
Practice Address - Fax:601-649-4487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-02
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS05068/11.1332B00000X
MS05321/02.53336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00330648Medicaid
MS00440829Medicaid
MS1285669150OtherMEDICARE NPI
MS6494730001Medicare NSC
MS00440829Medicaid