Dme
Durable Medical Equipment & Medical Supplies in Kathleen, GA. Organization (NPI-2).
NPI number1124458567
StatusActive
Last updated in NPPESJul 21, 2022
Details
- NPI
- 1124458567
- Entity type
- Organization (NPI-2)
- Legal business name
- Dme
- Organization subpart
- No
- Enumeration date
- Nov 21, 2013
- Last updated
- Jul 21, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 332B00000X | Durable Medical Equipment & Medical Supplies | 1 | GA | Yes |
Practice location
123 Sylvan DrKathleen, GA 31047-2418
Phone 478-397-0125
Mailing address
123 Sylvan DrP O Box 244
Kathleen, GA 31047-2418
Phone 478-397-0125
Authorized official
Brian Williams
Ceo
4783970125
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