Provider Demographics
NPI:1447881966
Name:PATTON DURABLE EQUIPMENT SUPPLIES,LLC.
Entity type:Organization
Organization Name:PATTON DURABLE EQUIPMENT SUPPLIES,LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:C
Authorized Official - Last Name:PATTON
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:601-708-5097
Mailing Address - Street 1:305 CLINTON BLVD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MS
Mailing Address - Zip Code:39056-5217
Mailing Address - Country:US
Mailing Address - Phone:601-708-5097
Mailing Address - Fax:601-708-5096
Practice Address - Street 1:305 CLINTON BLVD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MS
Practice Address - Zip Code:39056-5217
Practice Address - Country:US
Practice Address - Phone:601-708-5097
Practice Address - Fax:601-708-5096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-03
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies