Organization

Dura Med Southeast, Inc.

May also be knows as Southland Vital Care

Legal Business Name

Dura Med Southeast, Inc.

Also Known As

Southland Vital Care

NPI Number

1679519854

NPI Type

Organization

Enumeration Date

06/22/2006

Licenses

State

Alabama

License Number

111970

Contact
Information

Purpose

Mailing
Location

Address

PO BOX 190
100 E FRONT ST

City

Evergreen
Evergreen

State

AL
AL

Postal Code

36401-0190
36401-2927

Country

US
US

Telephone Number

(251) 578-1333
(251) 578-1333

Authorized Official

Name

Mr. Jack Floyd

Title or Position

PRESIDENT

Telephone Number

(251) 578-1333

Identifiers

Identifier

515-05269
16252100

Identifier State

AL
Unknown

Identifier Issuer

BCBS
OWCP

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 08/22/2020

Provider Address