Provider Demographics
NPI:1841372182
Name:FAMILY MEDICAL EQUIPMENT
Entity type:Organization
Organization Name:FAMILY MEDICAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERI
Authorized Official - Middle Name:
Authorized Official - Last Name:SHOUP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-224-3999
Mailing Address - Street 1:PO BOX 374
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:MS
Mailing Address - Zip Code:38603-0374
Mailing Address - Country:US
Mailing Address - Phone:662-224-3999
Mailing Address - Fax:662-224-3999
Practice Address - Street 1:711 RIPLEY AVE
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:MS
Practice Address - Zip Code:38603-7220
Practice Address - Country:US
Practice Address - Phone:662-224-3999
Practice Address - Fax:662-224-3999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1415332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00440368Medicaid
MS00440368Medicaid