Southeastern Scientific Supply Company LLC

Primary specialty

Nursing Facility Supplies (DME)Taxonomy code 332BN1400X

License

20113603522 Issued in GA

Legal business name

SOUTHEASTERN SCIENTIFIC SUPPLY COMPANY LLC

Practice address

6883 Justin Dr
Loganville, GA 30052-6401

Phone

(770) 913-8768

Fax

(770) 913-8762

NPI assigned

Jun 6, 2011

Organization subpart

No

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

Authorized official

Name

Mr. David Brain

Title

Owner/GM

Phone

(770) 913-8768

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1307318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307318400000",
    "number": "1871887091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6883 JUSTIN DR",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300526401",
            "telephone_number": "770-913-8768",
            "fax_number": "770-913-8762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6883 JUSTIN DR",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300526401",
            "telephone_number": "770-913-8768",
            "fax_number": "770-913-8762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN SCIENTIFIC SUPPLY COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-06",
        "last_updated": "2011-06-06",
        "status": "A",
        "authorized_official_last_name": "BRAIN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER/GM",
        "authorized_official_telephone_number": "770-913-8768",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": "GA",
            "license": "20113603522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nursing Facility Supplies (DME) in Loganville, GA
• Providers in Loganville, GA by specialty
• Nursing Facility Supplies (DME) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2011; 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.