Evelyn Ray LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

EVELYN RAY LLC

Practice address

12570 Lakeside Pkwy
Fayetteville, GA 30215-4002

Phone

(404) 946-9949

NPI assigned

Jul 12, 2019

Organization subpart

No

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

Authorized official

Name

Tami Williams

Title

Owner

Phone

(404) 956-9949

Specialties & licenses 2

Addresses

Other names 1

• Evelyn Ray Hair Co. Doing business as

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

{
    "created_epoch": "1562889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562889600000",
    "number": "1700438587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12570 LAKESIDE PKWY",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302154002",
            "telephone_number": "404-946-9949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12570 LAKESIDE PKWY",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302154002",
            "telephone_number": "404-946-9949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVELYN RAY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-12",
        "last_updated": "2019-07-12",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "TAMI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-956-9949"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evelyn Ray Hair Co.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Fayetteville, GA
• Providers in Fayetteville, 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 Jul 12, 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.