Devotion Medical Supply, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

305849627 Issued in GA

Legal business name

DEVOTION MEDICAL SUPPLY, INC.

Practice address

101 Kenwood Rd Ste 26
Fayetteville, GA 30214-3418

Phone

(678) 817-4418

Fax

(678) 817-4419

NPI assigned

Jun 22, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Efe Owen

Title

Manager

Phone

(678) 817-4418

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548892800000",
    "number": "1801024435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 KENWOOD RD STE 26",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302143418",
            "telephone_number": "678-817-4418",
            "fax_number": "678-817-4419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 KENWOOD RD STE 26",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302143418",
            "telephone_number": "678-817-4418",
            "fax_number": "678-817-4419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVOTION MEDICAL SUPPLY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-22",
        "last_updated": "2019-01-31",
        "status": "A",
        "authorized_official_last_name": "OWEN",
        "authorized_official_first_name": "EFE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "678-817-4418",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "GA",
            "license": "305849627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAYETTE COUNTY OCCUPATIONAL TAX CERTIFICATE",
            "identifier": "101190",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE TAX IDENTIFICATION",
            "identifier": "305849627",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Michelle Detherage, MS, BCBA
• Matthew Deutscher
• Joseph Donald Deveau, MD
• Rachael Deviese, PA-C
• Devotion Home Care Services LLC
• Adrienne Dewberry, LPN
• DHP of Piedmont PC
• Nimish Naresh Dhruva, MD
• Yancy T. Dials, MS
• Dialysis Clinic Inc.

• 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 Jan 31, 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.