Premier Shockwave, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PREMIER SHOCKWAVE, INC.

Practice address

750 Hammond Dr NE
Building 18 Suite 200
Atlanta, GA 30328-5532

Phone

(404) 256-4440

Fax

(404) 256-4446

NPI assigned

Nov 12, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Anthony Michael Stolarski

Title

President & Ceo

Phone

(404) 256-4440

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1289520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289520000000",
    "number": "1881995454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 HAMMOND DR NE",
            "address_2": "BUILDING 18 SUITE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285532",
            "telephone_number": "404-256-4440",
            "fax_number": "404-256-4446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 HAMMOND DR NE",
            "address_2": "BUILDING 18 SUITE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285532",
            "telephone_number": "404-256-4440",
            "fax_number": "404-256-4446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER SHOCKWAVE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-12",
        "last_updated": "2010-11-12",
        "status": "A",
        "authorized_official_last_name": "STOLARSKI",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "404-256-4440",
        "authorized_official_name_prefix": "Mr."
    },
    "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 Atlanta, GA
• Providers in Atlanta, 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 Nov 12, 2010; 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.