Abagan Medical Supplies
Organization Active NPI Durable Medical Equipment & Medical Supplies · Tucker, GA
NPI 1306022330 · NPPES record last updated Apr 10, 2009
Key facts
- NPI
- 1306022330
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Durable Medical Equipment & Medical Supplies 332B00000X
- License
- 08004787 (GA)
- Legal business name
- ABAGAN MEDICAL SUPPLIES
- Practice address
- 2179 Northlake Pkwy Ste 20
Tucker, GA 30084-4106 - Phone
- (770) 621-3090
- Fax
- (770) 621-3091
- NPI assigned
- Jan 22, 2008
- Organization subpart
- No
Authorized official
- Name
- Mr. Ekong A Umoren
- Title
- C.E.O.
- Phone
- (770) 621-3090
National Provider Directory
Locations
2179 Northlake Pkwy
Ste 20
Tucker, GA 30084
Phone (770) 621-3090
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 08004787 | GA | Yes |
Addresses
Primary practice location
2179 Northlake Pkwy Ste 20
Tucker, GA 30084-4106
Mailing address
2179 Northlake Pkwy Ste 20
Tucker, GA 30084-4106
Phone (770) 621-3090
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00201800 | Other | GA | STATE |
| 6051790002 | Other | GA | DME SUPPLIER NUMBER |
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 10, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.