Peach State Medical Supplies, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PEACH STATE MEDICAL SUPPLIES, LLC

Practice address

11815 Northfall LN
Suite 1003
Alpharetta, GA 30004-7973

Phone

(678) 446-0894

Fax

(770) 346-9394

NPI assigned

Sep 13, 2006

Last updated

Mar 18, 2008By 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

Andrew Robert Golde

Title

Vice-President

Phone

(404) 842-9939

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205798400000",
    "number": "1669577185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11815 NORTHFALL LN",
            "address_2": "SUITE 1003",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300047973",
            "telephone_number": "678-446-0894",
            "fax_number": "770-346-9394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11815 NORTHFALL LN",
            "address_2": "SUITE 1003",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300047973",
            "telephone_number": "678-446-0894",
            "fax_number": "770-346-9394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACH STATE MEDICAL SUPPLIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2008-03-18",
        "status": "A",
        "authorized_official_last_name": "GOLDE",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "404-842-9939"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Souz Payne, REGISTERED NURSE
• Peace of Mind Psychological Service, LLC
• Peaceful Horizons Counseling, LLC
• Peach Medical Systems Associates LLC
• Peach Psychiatric Systems Associates LLC
• Peachtree Dental Group
• Peachtree Eye Associates P C
• Peachtree Medical Group LLC
• Peachtree Orthopaedic Clinic
• Peachtree Psychotherapy, P.C.

• Durable Medical Equipment & Medical Supplies in Alpharetta, GA
• Providers in Alpharetta, 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 Mar 18, 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.