Provider Demographics
NPI:1861810285
Name:DREW MEDICAL LLC
Entity type:Organization
Organization Name:DREW MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SALES MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:DALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-799-8132
Mailing Address - Street 1:5155 GALAXIE DR STE C-4
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39206-4309
Mailing Address - Country:US
Mailing Address - Phone:504-799-8132
Mailing Address - Fax:504-520-8941
Practice Address - Street 1:5155 GALAXIE DR STE C-4
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39206-4309
Practice Address - Country:US
Practice Address - Phone:504-799-8132
Practice Address - Fax:504-520-8941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-02
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies