Georgia State Medical Supply LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

GEORGIA STATE MEDICAL SUPPLY LLC

Practice address

1841 Peachtree Rd NE
Atlanta, GA 30309-1524

Phone

(678) 974-5866

Fax

(678) 974-5861

NPI assigned

May 11, 2012

Organization subpart

No

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

Authorized official

Name

Miss Malinda Waller

Title

Owner

Phone

(678) 974-5866

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1336694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384905600000",
    "number": "1073872040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1841 PEACHTREE RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091524",
            "telephone_number": "678-974-5866",
            "fax_number": "678-974-5861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1841 PEACHTREE RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091524",
            "telephone_number": "678-974-5866",
            "fax_number": "678-974-5861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA STATE MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-11",
        "last_updated": "2013-11-20",
        "status": "A",
        "authorized_official_last_name": "WALLER",
        "authorized_official_first_name": "MALINDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-974-5866",
        "authorized_official_name_prefix": "Miss"
    },
    "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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• All providers in Atlanta, GA
• Durable Medical Equipment & Medical Supplies in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2013; 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.