Procore Med, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PROCORE MED, LLC

Practice address

4154 Silver Peak Pkwy Ste F
Suwanee, GA 30024-6702

Phone

(770) 740-4484

Fax

(770) 777-8885

NPI assigned

Sep 29, 2022

Organization subpart

No

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

Authorized official

Name

Alana Baxter

Title

Vice President

Phone

(844) 740-4484

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Albert Baxter

  • Assistive Technology Practitioner Rehabilitation Counselor
  • Fort Worth, TX
  • NPI 1689535411
  NPD

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

{
    "created_epoch": "1664409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669680000000",
    "number": "1104540541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2528",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300240982",
            "telephone_number": "770-740-4484",
            "fax_number": "770-777-8885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4154 SILVER PEAK PKWY STE F",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246702",
            "telephone_number": "770-740-4484",
            "fax_number": "770-777-8885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROCORE MED, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-29",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A",
        "authorized_official_last_name": "BAXTER",
        "authorized_official_first_name": "ALANA",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "844-740-4484"
    },
    "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 Suwanee, GA
• Providers in Suwanee, 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 Nov 29, 2022; 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.