Gwinnett Supply Company LLC

Primary specialty

Dialysis Equipment & Supplies (DME)Taxonomy code 332BD1200X

Legal business name

GWINNETT SUPPLY COMPANY LLC

Practice address

605 Old Norcross Rd
Lawrenceville, GA 30046-4315

Phone

(770) 962-1231

Fax

(770) 513-2107

NPI assigned

Jun 27, 2007

Last updated

Feb 27, 2019By 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

Dr. Kirti K Shah, M.D.NPI 1700881612

Title

Medical Director

Phone

(770) 962-1231

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kirti K Shah, MD

  • Nephrology Physician
  • Lawrenceville, GA
  • NPI 1700881612
  NPD (past) Authorized official

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551225600000",
    "number": "1467659144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 OLD NORCROSS RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464315",
            "telephone_number": "770-962-1231",
            "fax_number": "770-513-2107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 OLD NORCROSS RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464315",
            "telephone_number": "770-962-1231",
            "fax_number": "770-513-2107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GWINNETT SUPPLY COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-27",
        "last_updated": "2019-02-27",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "KIRTI",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "770-962-1231",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332BD1200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Dialysis Equipment & Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000784693A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gwinnett Pulmonary & Sleep, P.C.
• Gwinnett Pulmonary Group
• Gwinnett Smile Design
• Gwinnett Sportherapy
• Gwinnett Supply Company LLC (Nephron Pharmacy)
• Gwinnett Supply Company LLC (Nephron Dispensary)
• Gwinnett Surgery Center, LLC
• Gwinnett Surgical Associates, LLC
• Gwinnett Surgical Associates, LLP
• Gwinnett Surgical Specialists LLC

• Durable Medical Equipment & Medical Supplies in Lawrenceville, GA
• Providers in Lawrenceville, 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 Feb 27, 2019; 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.