Primary Care Medical Supply of Atlanta LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PRIMARY CARE MEDICAL SUPPLY OF ATLANTA LLC

Doing business as

Primary Care Medical Supply

Practice address

4760 Hammermill Rd Ste 205
Tucker, GA 30084-6612

Phone

(770) 881-8010

Fax

(770) 492-3371

NPI assigned

Mar 8, 2017

Organization subpart

No

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

Authorized official

Name

Mr. James BlairNPI 1528750049

Title

Manager Director

Phone

(770) 881-8010

Specialties & licenses 2

Addresses

Other names 1

• Primary Care Medical Supply Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 1

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

• James Blair

  • Contractor
  • Tucker, GA
  • NPI 1528750049
  NPD Authorized official

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

{
    "created_epoch": "1488931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685059200000",
    "number": "1194266247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4760 HAMMERMILL RD STE 205",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300846612",
            "telephone_number": "770-881-8010",
            "fax_number": "770-492-3371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4760 HAMMERMILL RD STE 205",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300846612",
            "telephone_number": "770-881-8010",
            "fax_number": "770-492-3371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE MEDICAL SUPPLY OF ATLANTA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-08",
        "last_updated": "2023-05-26",
        "certification_date": "2023-03-09",
        "status": "A",
        "authorized_official_last_name": "BLAIR",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "MANAGER DIRECTOR",
        "authorized_official_telephone_number": "770-881-8010",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Primary Care Medical Supply",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Tucker, GA
• Providers in Tucker, 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 May 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.