Blackwater Medical LLC
NPI #1033343603 in Hattiesburg, Mississippi
Provider Information
- NPI Number
- 1033343603
- Entity Type
- Organization
- Organization Name
- Blackwater Medical LLC
- Primary Specialty
- Durable Medical Equipment & Medical Supplies
- Enumeration Date
- May 11, 2009
- Last Updated
- May 11, 2009
Practice Location
- Address
- 1 LINCOLN PKWY
- Address 2
- SUITE #305
- City
- Hattiesburg
- State
- Mississippi
- ZIP Code
- 39402-3262
- Phone
- (601) 264-0059
Authorized Official
- Name
- MR. JAMES F COLLINS
- Title
- PRESIDENT
- Phone
- (601) 264-0059
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies |
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