Kennesaw Medical Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

KENNESAW MEDICAL SUPPLY

Practice address

3600 Cherokee St NW
Suite 120
Kennesaw, GA 30144-2027

Phone

(770) 425-8709

Fax

(770) 425-8744

NPI assigned

Apr 13, 2007

Organization subpart

No

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

Authorized official

Name

Giovanna Tamara Hernandez

Title

Owner

Phone

(770) 974-6797

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218499200000",
    "number": "1619191137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 CHEROKEE ST NW",
            "address_2": "SUITE 120",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301442027",
            "telephone_number": "770-425-8709",
            "fax_number": "770-425-8744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 CHEROKEE ST NW",
            "address_2": "SUITE 120",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301442027",
            "telephone_number": "770-425-8709",
            "fax_number": "770-425-8744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNESAW MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2008-08-12",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "GIOVANNA",
        "authorized_official_middle_name": "TAMARA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-974-6797"
    },
    "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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• Kennesaw Modern Dentistry, PC
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• Kennesaw Pediatric Dentistry
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• Durable Medical Equipment & Medical Supplies in Kennesaw, GA
• Providers in Kennesaw, 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 Aug 12, 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.