Peach Medical Management

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

1149713 Issued in GA

Legal business name

PEACH MEDICAL MANAGEMENT

Practice address

129 Norwood Rd
Warrenton, GA 30828-9734

Phone

(478) 783-4988

NPI assigned

Oct 19, 2005

Organization subpart

No

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

Authorized official

Name

Deborah Coley

Title

Medicare Part B Coordinator

Phone

(478) 783-4988

Specialties & licenses 1

Addresses

Other names 1

• Warrenton Health and Rehabilitation Center Doing business as

Tax ID family

Peach Medical Management2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Peach Medical Management

  • Nursing Facility Supplies (DME)
  • Hawkinsville, GA
  • NPI 1851597652
  NPD tax ID

Locations

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1851380174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 INDUSTRIAL BLVD",
            "address_2": "P.O. BOX 1033",
            "city": "HAWKINSVILLE",
            "state": "GA",
            "postal_code": "310362106",
            "telephone_number": "478-783-4988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 NORWOOD RD",
            "city": "WARRENTON",
            "state": "GA",
            "postal_code": "308289734",
            "telephone_number": "478-783-4988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACH MEDICAL MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COLEY",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "MEDICARE PART B COORDINATOR",
        "authorized_official_telephone_number": "478-783-4988"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "GA",
            "license": "1149713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Warrenton Health and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Muhammad Talha Jamil, M.B.B.S. M.D
• Miek C. Johnson, PA
• Tiffany Johnson, FNP
• Jennifer Elaine Kearse, MACCCSLP
• Richard E Melcher, MD
• Point of Need, Inc
• Richard Austin Sease
• Selectis Warrenton LLC
• Tender Heart Personal Care Home
• The Dollhouse Trap

• All providers in Warrenton, GA
• 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.