Phases Medical Equipment and Supplies

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PHASES MEDICAL EQUIPMENT AND SUPPLIES

Practice address

4930 Governors Dr
409
Forest Park, GA 30297-6101

Phone

(404) 675-9100

Fax

(404) 675-9102

NPI assigned

Jun 12, 2010

Last updated

Jul 21, 2022By 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

Mrs. Meshall Petteway

Title

Ceo

Phone

(404) 675-9100

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1276300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1417278599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4930 GOVERNORS DR",
            "address_2": "409",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302976101",
            "telephone_number": "404-675-9100",
            "fax_number": "404-675-9102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4930 GOVERNORS DR",
            "address_2": "409",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302976101",
            "telephone_number": "404-675-9100",
            "fax_number": "404-675-9102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHASES MEDICAL EQUIPMENT AND SUPPLIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-12",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "PETTEWAY",
        "authorized_official_first_name": "MESHALL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-675-9100",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Parkway Family Optical
• Parkway Laboratories, LLC (Parkway Labs)
• Parkway Professional Group LLC
• Parkway Professional Group LLC
• Kanksha Patel, DC
• Bobby Teron Pittman Jr., DDS
• Plymouth Point
• PMR Georgia Holding, LLC (Jencare Senior Medical Center Forest Park)
• Reona Yavette Porter, BFS, PPN
• Regina Powell, NP

• Durable Medical Equipment & Medical Supplies in Forest Park, GA
• Providers in Forest Park, 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 Jul 21, 2022; 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.