CHISOM MEDICAL GROUP LLC. NPI 1205895679

NPI Information

NPI: 1205895679
Provider Name: CHISOM MEDICAL GROUP LLC.

Doing Business As: JACKSON MEDICAL SUPPLY

Classification: Durable Medical Equipment & Medical Supplies - 332BX2000X
Entity Type: Organization

Specialization: Oxygen Equipment & Supplies

Address:
129 E MCDOWELL RD
JACKSON, MS
ZIP 39204
Phone: (601) 376-0855
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CHISOM MEDICAL GROUP LLC. is an oxygen equipment and supplies durable medical equipment medical supplies in Jackson, MS. CHISOM MEDICAL GROUP LLC. NPI is 1205895679. The provider is registered as an organization entity type.
The provider Is Doing Business As Jackson Medical Supply.

The provider's business location address is:

129 E MCDOWELL RD
JACKSON, MS
ZIP 39204-719
Phone: (601) 376-0855
Fax: (601) 376-0854

The provider's authorized official is Sylvester Chukwuemeka Oguh .
The authorized official title is President/ceo and has the following contact phone number (601) 454-3878.

The enumeration date for this NPI number is 3/22/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	332BX2000X	Durable Medical Equipment & Medical Supplies	Oxygen Equipment & Supplies	06365 / 11.1	MISSISSIPPI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00172074	MEDICAID	MISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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