Organization Active NPI

Med South Surgical, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Alpharetta, GA
National Provider Identifier
1114052396
Registry record updated Feb 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
MED SOUTH SURGICAL, INC.
Practice address
6535 Shiloh Rd
Suite C600
Alpharetta, GA 30005-1608
Phone
(770) 292-9747
Fax
(770) 292-9754
NPI assigned
Feb 21, 2007
Last updated
Feb 7, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2012

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

Authorized official

Name
Mr. Eric Stevens
Title
DME Manager
Phone
(770) 292-9747

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

6535 Shiloh Rd
Suite C600
Alpharetta, GA 30005-1608

Mailing address

PO Box 28126
Atlanta, GA 30358-0126
Phone (770) 292-9747

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120124000671 GA DME Supplier - Medical Supply Company 0547437014 Practice locations: Alpharetta, GA

National Provider Directory

National Provider Directory

Locations

430 Winkler Dr
Ste 100
Alpharetta, GA 30004
Phone (470) 395-0835

6535 Shiloh Rd
Ste C600
Alpharetta, GA 30005
Phone (770) 292-9747

6840 Meadowridge Ct
Alpharetta, GA 30005
Phone (470) 395-0835

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328572800000",
    "number": "1114052396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 28126",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303580126",
            "telephone_number": "770-292-9747",
            "fax_number": "770-292-9754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6535 SHILOH RD",
            "address_2": "SUITE C600",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300051608",
            "telephone_number": "770-292-9747",
            "fax_number": "770-292-9754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED SOUTH SURGICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2012-02-07",
        "status": "A",
        "authorized_official_last_name": "STEVENS",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "DME MANAGER",
        "authorized_official_telephone_number": "770-292-9747",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.