Blue Eagle DME

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

BLUE EAGLE DME

Practice address

1110 Eagles Landing Pkwy
Stockbridge, GA 30281-7271

Phone

(770) 474-0842

Fax

(478) 237-2217

NPI assigned

Jun 3, 2006

Last updated

Aug 22, 2020By 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

Donald Wilson, RPHNPI 1043256704

Title

Secretary

Phone

(478) 237-3609

Specialties & licenses 1

Addresses

Practitioners 2

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.

• Donald E Wilson, R.PH

  • Pharmacist
  • Swainsboro, GA
  • NPI 1043256704
  Authorized official Same address or phone
• David Michael Key, RPH

  • Pharmacist
  • Stockbridge, GA
  • NPI 1588186076
  NPD (past)

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699713545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1128",
            "city": "SWAINSBORO",
            "state": "GA",
            "postal_code": "304011128",
            "telephone_number": "478-237-3609",
            "fax_number": "478-237-3609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 EAGLES LANDING PKWY",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817271",
            "telephone_number": "770-474-0842",
            "fax_number": "478-237-2217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE EAGLE DME",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "478-237-3609",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samira Bland, LPC
• Tacoria Shakiyah Bloodser
• Bloom and Restore Behavior and Education Service LP
• Rhonda Carolyn Bloschock, CRNA
• Penny Blount, PA-C
• Christopher Boddie
• Body Mechanics Physical Therapy
• Grace Bogert, PA-C
• Amalia Marie Bonano-Rios, MD
• Tina Bonds

• Durable Medical Equipment & Medical Supplies in Stockbridge, GA
• Providers in Stockbridge, 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 22, 2020; 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.