Southern Illinois Surgical Appliance Co

NPI 1104807056 - Durable Medical Equipment & Medical Supplies - 332BX2000X

NPI Details
NPI 1104807056
Enumeration Date 11/08/2005
Last Updated 04/20/2008
Entity Type Healthcare Provider
Active Over 11 years ago
Authorized Information
Name RALPH RANDOLPH RALPH
Position PRESIDENT
Phone (618) 932-3157
Fax (618) 932-3031
Practice Location
19 W FRANKFORT PLZ
WEST FRANKFORT IL, 62896-4964, US
Phone (618) 932-3157
Fax (618) 932-3031
Business Location
19 W FRANKFORT PLZ
WEST FRANKFORT IL, 62896-4964, US
Phone (618) 932-3157
Fax (618) 932-3031
Toxanomy
Taxonomy Code 332BX2000X
License State Illinois
License Number 2032-1120
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According to our database, Southern Illinois Surgical Appliance Co NPI is 1104807056, taxonomy code is 332BX2000X and license number is 2032-1120, license state is located at Illinois. Southern Illinois Surgical Appliance Co physically located at 19 W Frankfort Plz, West Frankfort IL, 62896-4964. NPI Number 1033115704 has the healthcare provider type.

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1104807056 NPI number is provided on an as is basis without warranty of any kind. 1104807056 is maintained by the National Plan & Provider Enumeration System. The contents of Southern Illinois Surgical Appliance Co are for informational purposes only.