Premier Medical Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PREMIER MEDICAL SUPPLY

Practice address

1240 Highway 54 W
Suite 504
Fayetteville, GA 30214-4557

Phone

(770) 731-1935

Fax

(678) 840-9446

NPI assigned

Feb 28, 2017

Last updated

Feb 28, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jalen Uboh

Title

Ceo

Phone

(770) 731-1935

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1488240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488240000000",
    "number": "1851831507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 HIGHWAY 54 W",
            "address_2": "SUITE 504",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144557",
            "telephone_number": "770-731-1935",
            "fax_number": "678-840-9446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 HIGHWAY 54 W",
            "address_2": "SUITE 504",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144557",
            "telephone_number": "770-731-1935",
            "fax_number": "678-840-9446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-28",
        "last_updated": "2017-02-28",
        "status": "A",
        "authorized_official_last_name": "UBOH",
        "authorized_official_first_name": "JALEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-731-1935"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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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 Feb 28, 2017; 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.