Provider Demographics
NPI:1932388279
Name:SAVEREX DRUG
Entity type:Organization
Organization Name:SAVEREX DRUG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:KNOTTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-563-7651
Mailing Address - Street 1:287 HIGHWAY 6 W
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38606-2557
Mailing Address - Country:US
Mailing Address - Phone:662-563-7651
Mailing Address - Fax:662-563-7653
Practice Address - Street 1:287 HIGHWAY 6 W
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:MS
Practice Address - Zip Code:38606-2557
Practice Address - Country:US
Practice Address - Phone:662-563-7651
Practice Address - Fax:662-563-7653
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAVEREX DRUG
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-02
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00034096Medicaid
4383240001Medicare NSC