Pak Medical, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PAK MEDICAL, INC.

Practice address

5745 Wendy Bagwell Pkwy Ste 32
Hiram, GA 30141-2885

Phone

(770) 222-6678

Fax

(770) 222-6680

NPI assigned

Dec 4, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Anita Kennerley

Title

Vice President

Phone

(770) 222-6678

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279152000000",
    "number": "1053479956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1042",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301411042",
            "telephone_number": "770-222-6678",
            "fax_number": "770-222-6680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5745 WENDY BAGWELL PKWY STE 32",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301412885",
            "telephone_number": "770-222-6678",
            "fax_number": "770-222-6680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAK MEDICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2010-07-15",
        "status": "A",
        "authorized_official_last_name": "KENNERLEY",
        "authorized_official_first_name": "ANITA",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "770-222-6678"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Hiram, GA
• Providers in Hiram, GA by specialty
• Durable Medical Equipment & Medical Supplies in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.