Duluth Medical Supplies LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

DULUTH MEDICAL SUPPLIES LLC

Practice address

3675 Crestwood Pkwy NW Ste 409
Duluth, GA 30096-5133

Phone

(770) 817-7586

Fax

(404) 481-2677

NPI assigned

Jun 27, 2024

Organization subpart

No

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

Authorized official

Name

Raed Hareb

Title

President

Phone

(706) 351-5894

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1719446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719446400000",
    "number": "1790520120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3675 CRESTWOOD PKWY NW STE 409",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300965133",
            "telephone_number": "770-817-7586",
            "fax_number": "404-481-2677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3675 CRESTWOOD PKWY NW STE 409",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300965133",
            "telephone_number": "770-817-7586",
            "fax_number": "404-481-2677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DULUTH MEDICAL SUPPLIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-27",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A",
        "authorized_official_last_name": "HAREB",
        "authorized_official_first_name": "RAED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "706-351-5894"
    },
    "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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• Durable Medical Equipment & Medical Supplies in Duluth, GA
• Providers in Duluth, 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 Jun 27, 2024; 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.