Complete Medical Supply&Equipment;LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

20100038403 Issued in GA

Legal business name

COMPLETE MEDICAL SUPPLY&EQUIPMENT;LLC

Practice address

6116 Mableton Pkwy SW Ste 128
Mableton, GA 30126-4305

Phone

(678) 213-1055

Fax

(678) 213-1056

NPI assigned

Jul 29, 2005

Last updated

Nov 9, 2023By 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

Bassey Udom

Title

Manager

Phone

(678) 213-1055

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699488000000",
    "number": "1588664601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1333",
            "city": "LITHIA SPRINGS",
            "state": "GA",
            "postal_code": "301221166",
            "telephone_number": "678-213-1055",
            "fax_number": "678-213-1056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6116 MABLETON PKWY SW STE 128",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301264305",
            "telephone_number": "678-213-1055",
            "fax_number": "678-213-1056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE MEDICAL SUPPLY&EQUIPMENT;LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-29",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A",
        "authorized_official_last_name": "UDOM",
        "authorized_official_first_name": "BASSEY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "678-213-1055"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "GA",
            "license": "20100038403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "631317089A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Mableton, GA
• Providers in Mableton, 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 Nov 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.