Organization Active NPI

Agape Medical Supply & Durable Medical Equipment

  • Oxygen Equipment & Supplies (DME)
  • Atlanta, GA
National Provider Identifier
1104009802
Registry record updated Dec 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X
Legal business name
AGAPE MEDICAL SUPPLY & DURABLE MEDICAL EQUIPMENT
Practice address
2564 Peyton Woods TRL SW
Atlanta, GA 30311-2157
Phone
(404) 696-9826
Fax
(404) 696-9826
NPI assigned
Dec 17, 2007
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mr. Ronald Wynn
Title
Director of Business Development
Phone
(404) 310-0803

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Agape Medical Supply Durable Medical Equipment (2 organizations share this tax ID)

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Oxygen Equipment & Supplies (DME) 332BX2000X GA Primary

Addresses

NPPES NPI Registry

Primary practice location

2564 Peyton Woods TRL SW
Atlanta, GA 30311-2157

Mailing address

8202 Lullwater CT
Jonesboro, GA 30236-3963
Phone (404) 435-5931

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 17, 2007.

{
    "created_epoch": "1197849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197849600000",
    "number": "1104009802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8202 LULLWATER CT",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302363963",
            "telephone_number": "404-435-5931",
            "fax_number": "404-696-9826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2564 PEYTON WOODS TRL SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303112157",
            "telephone_number": "404-696-9826",
            "fax_number": "404-696-9826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGAPE MEDICAL SUPPLY & DURABLE MEDICAL EQUIPMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-17",
        "last_updated": "2007-12-17",
        "status": "A",
        "authorized_official_last_name": "WYNN",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "DIRECTOR OF BUSINESS DEVELOPMENT",
        "authorized_official_telephone_number": "404-310-0803",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2007; 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.