Forever Active Medical, L.L.C.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

FOREVER ACTIVE MEDICAL, L.L.C.

Practice address

2852 Johnson Ferry Rd
Suite 200
Marietta, GA 30062-5686

Phone

(770) 642-9191

Fax

(770) 642-1580

NPI assigned

Jan 29, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Scott Jason Paul

Title

President

Phone

(770) 642-9191

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1201564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222992000000",
    "number": "1285811554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2852 JOHNSON FERRY RD",
            "address_2": "SUITE 200",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300625686",
            "telephone_number": "770-642-9191",
            "fax_number": "770-642-1580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2852 JOHNSON FERRY RD",
            "address_2": "SUITE 200",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300625686",
            "telephone_number": "770-642-9191",
            "fax_number": "770-642-1580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREVER ACTIVE MEDICAL, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-29",
        "last_updated": "2008-10-03",
        "status": "A",
        "authorized_official_last_name": "PAUL",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "JASON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-642-9191",
        "authorized_official_name_prefix": "Mr."
    },
    "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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• All providers in Marietta, GA
• Durable Medical Equipment & Medical Supplies in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2008; 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.