SOUTHERN EXPRESS MEDICAL SUPPLY INC NPI 1265431928

NPI Information

NPI: 1265431928
Provider Name: SOUTHERN EXPRESS MEDICAL SUPPLY, INC
Classification: Durable Medical Equipment & Medical Supplies - 332BP3500X
Entity Type: Organization

Specialization: Parenteral & Enteral Nutrition

Address:
125 CHURCH ST
SUITE B
GEORGIANA, AL
ZIP 36033
Phone: (334) 376-0003
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SOUTHERN EXPRESS MEDICAL SUPPLY, INC is a parenteral and enteral nutrition durable medical equipment medical supplies in Georgiana, AL. SOUTHERN EXPRESS MEDICAL SUPPLY, INC NPI is 1265431928. The provider is registered as an organization entity type.

The provider's business location address is:

125 CHURCH ST
SUITE B
GEORGIANA, AL
ZIP 36033
Phone: (334) 376-0003
Fax: (334) 376-5777

The provider's authorized official is Michael Bruce .
The authorized official title is Owner and has the following contact phone number (334) 376-0003.

The enumeration date for this NPI number is 7/15/2005 and was last updated on 10/12/2015.

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	332BP3500X	Durable Medical Equipment & Medical Supplies	Parenteral & Enteral Nutrition			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	51077252	OTHER	ALABAMA	BCBS PROVIDER NUMBER
2	000077252	MEDICAID	ALABAMA
3	1191000001	MEDICARE ID-TYPE UNSPECIFIED	ALABAMA	PROVIDER ID NUMBER
4	1191000001	MEDICARE NSC	ALABAMA
5	305157	OTHER	ALABAMA	HEALTH INS CORP OF AL
6	========= 36033 0000	OTHER	ALABAMA	WPS TRICARE PROVIDER NUM

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: 11/14/2023

NPI Synchronization or Removal

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