NPIMap

Organization Active NPI

Ib Medsupply Inc

  • Durable Medical Equipment & Medical Supplies
  • Marietta, GA
National Provider Identifier
1750367157
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
IB MEDSUPPLY INC
Practice address
5040 Lake Fjord Pass
Marietta, GA 30068-1640
Phone
(770) 650-4625
Fax
(770) 650-4625
NPI assigned
Dec 16, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Inna Gendler
Title
Owner
Phone
(770) 650-4625

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

5040 Lake Fjord Pass
Marietta, GA 30068-1640

Mailing address

5040 Lake Fjord Pass
Marietta, GA 30068-1640
Phone (770) 650-4625

Other identifiers 1

IdentifierTypeStateIssuer
00745324AMedicaidGA

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1750367157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5040 LAKE FJORD PASS",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300681640",
            "telephone_number": "770-650-4625",
            "fax_number": "770-650-4625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5040 LAKE FJORD PASS",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300681640",
            "telephone_number": "770-650-4625",
            "fax_number": "770-650-4625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IB MEDSUPPLY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GENDLER",
        "authorized_official_first_name": "INNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-650-4625",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00745324A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • 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.