Heritage Medical Supply LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

HERITAGE MEDICAL SUPPLY LLC

Practice address

155 Westridge Pkwy Ste 217
McDonough, GA 30253

Phone

(678) 782-5702

NPI assigned

Apr 23, 2018

Last updated

Apr 27, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Robert Corkhill

Title

Owner

Phone

(954) 993-9991

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1524441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587945600000",
    "number": "1275021586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 WESTRIDGE PKWY STE 218",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302533051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 WESTRIDGE PKWY STE 217",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "30253",
            "telephone_number": "678-782-5702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-23",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A",
        "authorized_official_last_name": "CORKHILL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-993-9991"
    },
    "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 McDonough, GA
• Providers in McDonough, 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 Apr 27, 2020; 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.