Provider Demographics
NPI:1588711634
Name:STONE MEDCO INC
Entity type:Organization
Organization Name:STONE MEDCO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-540-7404
Mailing Address - Street 1:PO BOX 125
Mailing Address - Street 2:
Mailing Address - City:LUDLOW
Mailing Address - State:MS
Mailing Address - Zip Code:39098-0125
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3706 RIVER BEND ROAD
Practice Address - Street 2:
Practice Address - City:LUDLOW
Practice Address - State:MS
Practice Address - Zip Code:39098
Practice Address - Country:US
Practice Address - Phone:601-540-7404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS332B00000X, 332BD1200X, 332BN1400X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered332BD1200XSuppliersDurable Medical Equipment & Medical SuppliesDialysis Equipment & Supplies
Not Answered332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
Not Answered332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies