Organization Active NPI

Cotton Ancillary Services, LLC

  • Durable Medical Equipment & Medical Supplies
  • Marietta, GA
National Provider Identifier
1194737809
Registry record updated Feb 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
COTTON ANCILLARY SERVICES, LLC
Practice address
2862 Johnson Ferry Rd
Suite 200
Marietta, GA 30062-8342
Phone
(770) 650-6672
Fax
(770) 650-6682
NPI assigned
Aug 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2010

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

Authorized official

Name
Mr. M. Scott Hardin II
Title
President
Phone
(770) 650-6672

Specialties & licenses 1

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

Addresses

Primary practice location

2862 Johnson Ferry Rd
Suite 200
Marietta, GA 30062-8342

Mailing address

2862 Johnson Ferry Rd
Suite 200
Marietta, GA 30062-8342
Phone (770) 650-6672

Other identifiers 4

IdentifierTypeStateIssuer
4582219MedicaidTN
009913998MedicaidAL
000904879AMedicaidGA
200803670MedicaidIN

Other names 1

  • Brentwood Ancillary Services, LLC Former legal business name

National Provider Directory

National Provider Directory

Locations

2862 Johnson Ferry Rd
Ste 200
Marietta, GA 30062
Phone (770) 650-6672

NPI Registry JSON

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265587200000",
    "number": "1194737809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2862 JOHNSON FERRY RD",
            "address_2": "SUITE 200",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300628342",
            "telephone_number": "770-650-6672",
            "fax_number": "770-650-6682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2862 JOHNSON FERRY RD",
            "address_2": "SUITE 200",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300628342",
            "telephone_number": "770-650-6672",
            "fax_number": "770-650-6682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COTTON ANCILLARY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-12",
        "last_updated": "2010-02-08",
        "status": "A",
        "authorized_official_last_name": "HARDIN",
        "authorized_official_first_name": "M.",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-650-6672",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4582219",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009913998",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000904879A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200803670",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brentwood Ancillary Services, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2010; 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.