Active NPI
Cotton Ancillary Services, LLC
- Durable Medical Equipment & Medical Supplies
- Marietta, GA
National Provider Identifier
1194737809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4582219 | Medicaid | TN | |
| 009913998 | Medicaid | AL | |
| 000904879A | Medicaid | GA | |
| 200803670 | Medicaid | IN |
Other names 1
- Brentwood Ancillary Services, LLC
National Provider Directory
National Provider DirectoryLocations
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.